Spirocyclic thrombin receptor antagonists

ABSTRACT

Heterocyclic-substituted tricyclics of the formula  
                 
or a pharmaceutically acceptable salt or solvate of said compound, isomer or racemic mixture wherein  
        represents an optional double bond, the dotted line is optionally a bond or no bond, resulting in a double bond or a single bond, as permitted by the valency requirement and wherein A n , E n , M n , U n , G n , J n , K n , R 9 , R 10 , R 11 , R 32 , R 33 , B and Het are herein defined and the remaining substituents are as defined in the specification, are disclosed, as well as pharmaceutical compositions containing them and a method of treating diseases associated with thrombosis, atherosclerosis, restenosis, hypertension, angina pectoris, arrhythmia, heart failure, and cancer by administering said compounds. Combination therapy with other cardiovascular agents is also claimed.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application No.60/666,931 filed on Mar. 31, 2005.

BACKGROUND OF THE INVENTION

The present invention relates to himbacine derivatives, which can beuseful as thrombin receptor antagonists in the treatment of diseasesassociated with thrombosis, atherosclerosis, restenosis, hypertension,angina pectoris, arrhythmia, heart failure, cerebral ischemia, stroke,neurodegenerative diseases and cancer. Thrombin receptor antagonists arealso known as protease activated receptor-1 (PAR-1) antagonists. Thecompounds of the invention also can be useful as cannabinoid (CB₂)receptor inhibitors for the treatment of rheumatoid arthritis, systemiclupus erythematosus, multiple sclerosis, diabetes, osteoporosis, renalischemia, cerebral stroke, cerebral ischemia, nephritis, inflammatorydisorders of the lungs and gastrointestinal tract, and respiratory tractdisorders such as reversible airway obstruction, chronic asthma andbronchitis. The invention also relates to pharmaceutical compositionscomprising said compounds.

Thrombin is known to have a variety of activities in different celltypes. Thrombin receptors are known to be present in such cell types ashuman platelets, vascular smooth muscle cells, endothelial cells andfibroblasts. It is therefore expected that thrombin receptor antagonistswill be useful in the treatment of thrombotic, inflammatory,atherosclerotic and fibroproliferative disorders, as well as otherdisorders in which thrombin and its receptor play a pathological role.

Thrombin receptor antagonist peptides have been identified based onstructure-activity studies involving substitutions of amino acids onthrombin receptors. In Bernatowicz et al., J. Med. Chem., 39 (1996), p.4879-4887, tetra- and pentapeptides are disclosed as being potentthrombin receptor antagonists, for exampleN-trans-cinnamoyl-p-fluoroPhe-p-guanidinoPhe-Leu-Arg-NH₂ andN-trans-cinnamoyl-p-fluoroPhe-p-guanidinoPhe-Leu-Arg-Arg-NH₂. Peptidethrombin receptor antagonists are also disclosed in WO 94/03479,published Feb. 17, 1994.

Cannabinoid receptors belong to the superfamily of G-protein coupledreceptors. They are classified into the predominantly neuronal CB₁receptors and the predominantly peripheral CB₂ receptors. Thesereceptors exert their biological actions by modulating adenylate cyclaseand Ca⁺² and K⁺ currents. While the effects of CB₁ receptors areprincipally associated with the central nervous system, CB₂ receptorsare believed to have peripheral effects related to bronchialconstriction, immunomodulation and inflammation. As such, a selectiveCB₂ receptor binding agent is expected to have therapeutic utility inthe control of diseases associated with rheumatoid arthritis, systemiclupus erythematosus, multiple sclerosis, diabetes, osteoporosis, renalischemia, cerebral stroke, cerebral ischemia, nephritis, inflammatorydisorders of the lungs and gastrointestinal tract, and respiratory tractdisorders such as reversible airway obstruction, chronic asthma andbronchitis (R. G. Pertwee, Curr. Med. Chem. 6(8), (1999), 635; M.Bensaid, Molecular Pharmacology, 63 (4), (2003), 908.).

Himbacine, a piperidine alkaloid of the formula

has been identified as a muscarinic receptor antagonist. The totalsynthesis of (+)-himbacine is disclosed in Chackalamannil et al., J. Am.Chem. Soc., 118 (1996), p. 9812-9813.

Substituted tricyclic thrombin receptor antagonists are disclosed inU.S. Pat. No. 6,063,847, U.S. Pat. No. 6,326,380 and U.S. Ser. No.09/880222 (WO 01/96330) and Ser. No. 10/271715.

SUMMARY OF THE INVENTION

The present invention relates to compounds represented by the formula I:

or a pharmaceutically acceptable salt of said compound, wherein

represents a double bond or a single bond, as permitted by the valencyrequirement; with the proviso that R¹⁰ is absent when the carbon towhich R¹⁰ is attached is part of a double bond;

B is —(CH₂)_(n3)—, —(CH₂)—O—, —(CH₂)S—, —(CH₂)—NR⁶—, —C(O)NR⁶—.—NR⁶C(O)—,

—(CH₂)_(n4)CR¹²═CR^(12a)(CH₂)_(n5)— or —(CH₂)_(n4)C≡C(CH₂)_(n5)—,wherein n₃ is 0-5, n₄ and n₅ are independently 0-2, and R¹² and R^(12a)are independently selected from the group consisting of hydrogen, alkyland halogen;

A, E, G, J, K, M and U are independently selected from the groupconsisting of —N(R⁵⁴)—, —(CR¹R²)—, —O—,

—S—, —S(O)—, —S(O)₂— and

with the provisos that selection of A, E, G, J, K, M and U does notresult in adjacent oxygen or sulfur atoms and that at least one carbonatom appear between said oxygen, nitrogen or sulfur atoms;

each n is 0, 1 or 2 with the provisos that all n variables cannot be 0and that the total of n variables cannot be greater than 7;

Het is a mono-, bi- or tricyclic heteroaromatic group of 5 to 14 atomscomprised of 1 to 13 carbon atoms and 1 to 4 heteroatoms independentlyselected from the group consisting of N, O and S, with the proviso thatthere are no adjacent oxygen or sulfur atoms present in theheteroaromatic group, wherein a ring nitrogen can form an N-oxide or aquaternary group with an alkyl group, wherein Het is attached to B by acarbon atom ring member, and wherein the Het group is substituted by 1to 4 moieties, W, wherein each W is independently selected from thegroup consisting of hydrogen; alkyl; fluoroalkyl; difluoroalkyl;trifluoroalkyl; cycloalkyl; heterocycloalkyl; heterocycloalkylsubstituted by alkyl or alkenyl; alkenyl; R²¹-arylalkyl;R²¹-aryl-alkenyl; heteroaryl; heteroarylalkyl; heteroarylalkenyl;hydroxyalkyl; dihydroxyalkyl; aminoalkyl; alkylaminoalkyl;di-(alkyl)-aminoalkyl; thioalkyl; alkoxy; alkenyloxy; halogen; —NR⁴R⁵;—CN; —OH; —C(O)OR¹⁷; —COR¹⁶; —OS(O₂)CF₃; —CH₂OCH₂CF₃; alkylthio;—C(O)NR⁴R⁵; —OCHR⁶-phenyl; phenoxyalkyl; —NHCOR¹⁶; —NHSO₂R¹⁶; biphenyl;—OC(R⁶)₂COOR⁷; —OC(R⁶)₂C(O)NR⁴R⁵; alkoxy substituted by alkyl, amino or—NHC(O)OR¹⁷; aryl; aryl substituted by 1 to 3 substituents independentlyselected from the group consisting of alkyl, halogen, alkoxy,methylenedioxy, carboxylic acid, carboxamide, amine, urea, amide,sulfonamide, —CN, —CF₃, —OCF₃, —OH, alkylamino-, di-(alkyl)amino-,—NR²⁵R²⁶alkyl-, hydroxyalkyl-, —C(O)OR¹⁷, —COR¹⁷, —NHCOR¹⁶, —NHS(O)₂R¹⁶,—NHS(O)₂CH₂CF₃, —C(O)NR²⁵R²⁶, —NR²⁵—C(O)—NR²⁵R²⁶, —S(O)R¹⁶, —S(O)₂R¹⁶and —SR¹⁶; or alkyl optionally substituted with —NR¹R², —NR¹COR²,—NR¹CONR¹R², —NR¹C(O)OR², —NR¹S(O)₂R², —NR¹S(O)₂NR¹R², —C(O)OH,—C(O)OR¹, —CONR¹R²heteroaryl, hydroxyalkyl, alkyl or—S(O)₂-alkyl;—C(O)NR⁴R⁵ or heteroaryl;wherein adjacent carbons on theHet ring can optionally form a ring with a methylenedioxy group;

R¹ and R² are independently selected from the group consisting ofhydrogen, alkyl, fluoroalkyl, difluoroalkyl, trifluoroalkyl, cycloalkyl,alkenyl, alkoxy, arylalkyl, arylalkenyl, heteroarylalkyl,heteroarylalkenyl, hydroxy, hydroxyalkyl, alkoxyalkyl, aminoalkyl, aryland thioalkyl; or

R¹ and R² when attached to nitrogen, taken together, form a mono orbicyclic heterocyclic ring of 4 to 10 atoms, with 1-3 heteroatomsselected from —O—, —N—, —S—, —S(O)—, —S(O)₂— and

with the proviso that S and O ring atoms are not adjacent to each other,where said heterocyclic ring is unsubstituted or substituted with one ormore groups selected from alkyl, halogen, hydroxy, alkoxy, aryloxy andarylalkoxy;

R⁶ is hydrogen, alkyl or phenyl;

R⁷ is hydrogen or alkyl;

each R¹³ is independently selected from hydrogen, alkyl, cycloalkyl,haloalkyl, halogen, —(CH₂)_(n6)NHC(O)OR^(16b), —(CH₂)_(n6)NHC(O)R^(16b),—(CH₂)_(n6)NHC(O)NR⁴R⁵, —(CH₂)_(n6)NHSO₂R¹⁶, —(CH₂)_(n6)NHSO₂NR⁴R⁵, and—(CH₂)_(n6)C(O)NR²⁸R²⁹, where n₆ is 0-4;

each R¹⁴ is independently selected from the group consisting ofhydrogen, alkyl, —OH, alkoxy, arylalkyl, heteroaryl, heteroarylalkyl,heterocyclyl, heterocyclylalkyl, halogen, haloalkyl,—(CH₂)_(n6)NHC(O)OR^(16b), —(CH₂)_(n6)NHC(O)R^(16b),—(CH₂)_(n6)NHC(O)NR⁴R⁵, —(CH₂)_(n6)NHSO₂R¹⁶, —(CH₂)_(n6)NHSO₂NR⁴R⁵, and—(CH₂)_(n6)C(O)NR²⁸R²⁹ where n₆ is 0-4; where R⁴ and R⁵ areindependently selected from the group consisting of hydrogen, alkyl,phenyl, benzyl and cycloalkyl, or R⁴ and R⁵ together can form a ringwith the nitrogen to which they are attached, wherein said ring formedby R⁴ and R⁵ is optionally substituted with ═O, OH, OR¹ or —C(O)OH; or

R¹³ and R¹⁴ taken together form a spirocyclic or a heterospirocyclicring of 3-6 ring atoms, wherein said heterospirocyclic ring contains 2to 5 carbon ring atoms and 1 or 2 hetero ring atoms selected from thegroup consisting of O, S and N;

R¹⁶ is independently selected from the group consisting of hydrogen,alkyl, phenyl and benzyl;

R^(16a) is independently selected from the group consisting of hydrogen,alkyl, phenyl and benzyl;

R^(16b) is hydrogen, alkoxy, alkyl, alkoxyalkyl-, R²²—O—C(O)-alkyl-,cycloalkyl, R²¹-aryl, R²¹-arylalkyl, haloalkyl, alkenyl, halosubstituted alkenyl, alkynyl, halo substituted alkynyl, R²¹-heteroaryl,(R²¹-heteroaryl)-alkyl-, (R²¹-heterocycloalkyl)-alkyl-, R²⁸R²⁹N-alkyl-,R²⁸R²⁹N—C(O)-alkyl-, R²⁸R²⁹N—C(O)O-alkyl-, R²⁸OC(O)N(R²⁹)-alkyl-,R²⁸S(O)₂N(R²⁹)-alkyl-, R²⁸R²⁹N—C(O)—N(R²⁹)-alkyl-,R²⁸R²⁹N—S(O)₂N(R²⁹)-alkyl-, R²⁸—C(O)N(R²⁹)-alkyl-, R²⁸R²⁹N—S(O)₂-alkyl-,HOS(O)₂-alkyl-, (OH)₂P(O)₂-alkyl-, R²⁸—S-alkyl-, R²⁸—S(O)₂-alkyl- orhydroxyalkyl;

R¹⁷ is independently selected from the group consisting of hydrogen,alkyl, phenyl and benzyl;

R¹⁸ and R¹⁹ are hydrogen, alkyl, aryl, R²¹-aryl, heteroaryl, cycloalkyl,heterocyclyl, alkoxyalkyl, haloalkoxyalkyl, aryloxyalkyl,arylalkoxyalkyl, heteroaryloxyalkyl, heteroarylalkoxyalkyl,cycloalkyloxyalkyl, (heterocyclyl)alkyloxyalkyl, alkoxyalkyloxyalkyl,—S(O)₂-alkyl, —C(NH)NR¹R² or alkyl substituted with one or two moietiesselected from cycloalkyl, halogen, hydroxy, —NR¹R², —NR¹C(O)R²,—NR¹C(O)NR¹R², —NR¹C(O)OR², —NR¹S(O)₂R², —NR¹S(O)₂NR¹R², —C(O)OH,—C(O)OR¹ and —C(O)NR¹R²; or

R¹⁸ and R¹⁹ together with the nitrogen to which they are attached, forma mono or bicyclic heterocyclic ring of 4 to 10 atoms, having 1-3 heteroring atoms selected from —O—, —N—, —S—, —S(O)—, —S(O)²⁻ and

with the proviso that S and O atoms are not adjacent to each other, thering being unsubstituted or substituted with one or more groups selectedfrom alkyl, halogen, hydroxy, alkoxy, aryloxy, arylalkoxy, —NR¹R²,—NR¹COR², —NR¹C(O)NR¹R², —NR¹C(O)OR², —NR¹S(O)₂R², —NR¹S(O₂)NR¹R²,—C(O)OR¹, —CONR¹R² and alkyl substituted with —NR¹R², —NR¹COR²,—NR¹CONR¹R², —NR¹C(O)OR², —NR¹S(O)₂R², —NR¹S(O)₂NR¹R², —C(O)OR¹ or—CONR¹R²;

R²¹ is 1 to 3 moieties and each R²¹ is independently selected from thegroup consisting of hydrogen, —CN, —CF₃, —OCF₃, halogen, —NO₂, alkyl,—OH, alkoxy, alkylamino-, di-(alkyl)amino-, —NR²⁵R²⁶alkyl-,hydroxyalkyl-, —C(O)OR¹⁷, —COR¹⁷, —NHCOR¹⁶, —NHS(O)₂R¹⁶, —C(NH)—NH₂,—NHS(O)₂CH₂CF₃, —C(O)NR²⁵R²⁶, —NR²⁵—C(O)—NR²⁵R²⁶, —S(O)R¹⁶, —S(O)₂R¹⁶,—SR¹⁶; —SO₂NR⁴R⁵ and —CONR⁴R⁵; or two adjacent R²¹ moieties can form amethylenedioxy group;

R²² is hydrogen, alkyl, phenyl, benzyl, —COR¹⁶, —CONR¹⁸R¹⁹, —COR²³,—S(O)R³¹, —S(O)₂R³¹, —S(O₂)NR²⁴R²⁵ or —C(O)OR²⁷;

R²³ is

wherein R³⁵ and R³⁶ are independently selected from the group consistingof hydrogen, alkyl, and R³⁷-substituted alkyl, wherein R³⁷ is selectedfrom the group consisting of HO—, HS—, CH₂S—, —NH₂, phenyl,p-hydroxyphenyl and indolyl; or R²³ is alkyl; haloalkyl; alkenyl;haloalkenyl; alkynyl; cycloalkyl; cycloalkylalkyl; cycloalkylsubstituted by 1 to 3 substituents selected from the group consisting ofalkoxyalkyl, alkyl, halogen, hydroxy, alkoxy, aryloxy, arylalkoxy,—NR¹R², —NR¹C(O)R², —NR¹C(O)NR¹R², —NR¹C(O)OR², —NR¹S(O)₂R²,—NR¹S(O)₂NR¹R², —C(O)OH, —C(O)OR¹ and —CONR¹R²; aryl; aralkyl;heteroaryl; heterocycloalkyl; alkyl substituted with —NR¹R², —NR¹COR²,—NR¹CONR¹R², —NR¹C(O)OR², —NR¹S(O₂)R², —NR¹S(O₂)NR¹R², —C(O)OH,—C(O)OR¹, —CONR¹R² and —SO₃H;

R²⁴, R²⁵ and R²⁶ are independently selected from the group consisting ofhydrogen, alkyl, haloalkyl, alkenyl, alkynyl, aryl, aralkyl, cycloalkyl,halocycloalkyl, alkoxyalkyl, hydroxy and alkoxy;

R²⁷ is 1 to 3 moieties and each R²⁷ is selected from the groupconsisting of hydrogen, alkyl, and cycloalkyl, wherein R²⁷ is optionallysubstituted with —OH, —C(O)OH, halogen and alkoxy;

R²⁸ and R²⁹ are independently selected from the group consisting ofhydrogen, alkyl, alkoxy, arylalkyl, heteroaryl, heteroarylalkyl,hydroxyalkyl, alkoxyalkyl, heterocyclyl, heterocyclylalkyl, andhaloalkyl; or

R²⁸ and R²⁹ taken together form a spirocyclic or a heterospirocyclicring having 3-6 ring atoms;

R³² and R³³ are independently selected from the group consisting ofhydrogen, R³⁴-alkyl, R³⁴⁻alkenyl, R³⁴-alkynyl, R⁴⁰-heterocycloalkyl,R³⁸-aryl, R³⁸-aralkyl, R⁴²-cycloalkyl, R⁴²-cycloalkenyl, —OH, —OC(O)R⁴³,—C(O)OR⁴³, —C(O)R⁴³, —C(O)N⁴³R⁴⁴, —NR⁴³R⁴⁴, —NR⁴³C(O)R⁴⁴,—NR⁴³C(O)NR⁴⁴R⁴⁵, —NHS(O)₂R⁴³, —OC(O)NR⁴³R⁴⁴, R³⁷-alkoxy,R³⁷-alkenyloxy, R³⁷-alkynyloxy, R⁴⁰-heterocycloalkyloxy,R⁴²-cycloalkyloxy, R⁴²-cyclo-alkenyloxy, R⁴²-cycloalkyl-NH—, —NHSO₂NHR¹⁶and —CH(═NOR¹⁷);

or R³² and R³³ are combined to form a ring structure Q, below

where

R⁹ is hydrogen, OH, alkoxy, halogen or haloalkyl;

Q is fused R-substituted aryl, R-substituted heteroaryl, R-substitutedheterocyclic ring of 4-8 atoms containing 1-3 heteroatoms selected fromO, S, S(O), S(O)₂ and NR²² with the proviso that S and O cannot beadjacent to one another; or

Q is

R¹⁰ and R¹¹ are independently selected from the group consisting of R¹,fluoroalkoxy, difluoroalkoxy, trifluoroalkoxy, cycloalkyloxy,alkenyloxy, arylalkoxy, arylalkenyloxy, heteroarylalkoxy,heteroarylalkenyloxy, hydroxyalkoxy, alkoxyalkoxy, aminoalkoxy, aryloxyand thioalkoxy, provided that when ring Q is aromatic and the carbonatoms bearing R¹⁰ and R¹¹ are connected by a double bond, R¹⁰ and R¹¹are absent;

R is 1 to 5 moieties and each R is independently selected from the groupconsisting of hydrogen, alkyl, halogen, hydroxy, amino, alkylamino,dialkylamino, alkoxy, —COR¹⁶, —C(O)OR¹⁷, —C(O)NR⁴R⁵, —SOR¹⁶, —S(O₂)R¹⁶,—NR¹⁶COR^(16a), —NR¹⁶C(O)OR^(16a), —NR¹⁶CONR⁴R⁵, —NR¹⁶S(O₂)NR⁴R⁵,fluoroalkyl, difluoroalkyl, trifluoroalkyl, cycloalkyl, alkenyl,arylalkyl, arylalkenyl, heteroarylalkyl, heteroarylalkenyl,hydroxyalkyl, aminoalkyl, aryl and thioalkyl;

R³⁴ is 1 to 3 moieties and each R³⁴ is independently selected from thegroup consisting of hydrogen, halogen, —OH, alkoxy, R⁴⁷-aryl,alkyl-C(O)—, alkenyl-C(O)—, alkynyl-C(O)—, heterocycloalkyl,R³⁹-cycloalkyl, R³⁹-cycloalkenyl, —OC(O)R⁴³, —C(O)OR⁴³, —C(O)R⁴³,—C(O)NR⁴³R⁴⁴, —NR⁴³R⁴⁴, —NR⁴³C(O)R⁴⁴, —NR⁴³C(O)NR⁴⁴R⁴⁵, —NHSO₂R⁴³,—OC(O)NR⁴³R⁴⁴, R³⁹-alkenyloxy, R³⁹-alkynyloxy, R⁴⁰-heterocycloalkyloxy,R⁴²-cycloalkyloxy, R⁴²-cycloalkenyloxy, R⁴²-cycloalkyl-NH—, —NHSO₂NHR¹⁶and —CH(═NOR¹⁷);

R³⁸ is 1 to 3 moieties and each R³⁸ is independently selected from thegroup consisting of hydrogen, heterocycloalkyl, halogen, —C(O)OR⁴⁸, —CN,—C(O)NR⁴⁹R⁵⁰, —NR⁵¹C(O)R⁵², —OR⁴⁸, cycloalkyl, cycloalkylalkyl,alkylcycloalkylalkyl, haloalkylcycloalkylalkyl, hydroxyalkyl,alkoxyalkyl, and R⁵²-heteroaryl; or two R³⁸ groups on adjacent ringcarbons form a fused methylenedioxy group;

R³⁹ is 1 to 3 moieties and each R³⁹ is independently selected from thegroup consisting of hydrogen, halogen and alkoxy;

R⁴⁰ is 1 to 3 moieties and each R⁴⁰ is independently selected from thegroup consisting of hydrogen, R⁴¹-alkyl, R⁴¹-alkenyl and R⁴¹-alkynyl;

R⁴¹ is hydrogen, —OH or alkoxy;

R⁴² is 1 to 3 moieties and each R⁴² is independently selected from thegroup consisting of hydrogen, alkyl, —OH, alkoxy and halogen;

R⁴³, R⁴⁴ and R⁴⁵ are independently selected from the group consisting ofhydrogen, alkyl, alkoxyalkyl, R³⁸-arylalkyl, R⁴⁶-cycloalkyl,R⁵³⁻cycloalkylalkyl, R³⁸-aryl, heterocycloalkyl, heteroaryl,heterocycloalkylalkyl and heteroarylalkyl;

R⁴⁶ is hydrogen, alkyl, hydroxyalkyl or alkoxy;

R⁴⁷ is 1 to 3 moieties and each R⁴⁷ is independently selected from thegroup consisting of hydrogen, alkyl, —OH, halogen, —CN, alkoxy,trihaloalkoxy, alkylamino, di(alkyl)amino, —OCF₃, hydroxyalkyl, —CHO,—C(O)alkylamino, —C(O)di(alkyl)amino, —NH₂, —NHC(O)alkyl and—N(alkyl)C(O)alkyl;

R⁴⁸ is hydrogen, alkyl, haloalkyl, dihaloalkyl or trifluoroalkyl;

R⁴⁹ and R⁵⁰ are independently selected from the group consisting ofhydrogen, alkyl, aralkyl, phenyl and cycloalkyl, or R⁴⁹ and R⁵⁰ togetherare —(CH₂)₄—, —(CH₂)₅— or —(CH₂)₂—NR³⁹—(CH₂)₂— and form a ring with thenitrogen to which they are attached;

R⁵¹ and R⁵² are independently selected from the group consisting ofhydrogen, alkyl, aralkyl, phenyl and cycloalkyl, or R⁵¹ and R⁵² in thegroup —NR³⁹C(O)R⁴⁰, together with the nitrogen atoms to which they areattached, form a cyclic lactam having 5-8 ring members;

R⁵³ is hydrogen, alkoxy, —SOR¹⁶, —SO₂R¹⁷, —C(O)OR¹⁷, —C(O)NR¹⁸R¹⁹,alkyl, halogen, fluoroalkyl, difluoroalkyl, trifluoroalkyl, cycloalkyl,alkenyl, aralkyl, arylalkenyl, heteroarylalkyl, heteroarylalkenyl,hydroxyalkyl, aminoalkyl, aryl, thioalkyl, alkoxyalkyl oralkylaminoalkyl; and

R⁵⁴ is selected from the group consisting of hydrogen; alkyl;fluoroalkyl; difluoroalkyl; trifluoroalkyl; cycloalkyl; cycloalkylsubstituted by 1 to 3 substituents selected from the group consisting ofalkoxyalkyl, alkyl, halogen, hydroxy, alkoxy, aryloxy, arylalkoxy,—NR¹R², —NR¹C(O)R², —NR¹C(O)NR¹R², —NR¹C(O)OR², —NR¹S(O)₂R²,—NR¹S(O)₂NR¹R², —C(O)OH, —C(O)OR¹ and —CONR¹R²; alkenyl; alkoxy;arylalkyl; arylalkenyl; heteroarylalkyl; heteroarylalkenyl; hydroxy;alkoxy; hydroxyalkyl; alkoxyalkyl; aminoalkyl; aryl; heteroaryl;thioalkyl and alkyl substituted by 1 to 3 subsituents selected from thegroup consisting of urea, sulfonamide, carboxamide, carboxylic acid,carboxylic ester and sulfonyl urea;

and pharmaceutically acceptable salts thereof.

Pharmaceutical compositions comprising at least one compound of formulaI and a pharmaceutically acceptable carrier are also provided.

The compounds of the present invention can be useful as Thrombinreceptor antagonists, also known as PAR-1 antagonists, or as cannabinoid(CB₂) receptor antagonists. Thrombin receptor antagonist compounds ofthe present invention can have anti-thrombotic, anti-plateletaggregation, anti-atherosclerotic, anti-restenotic anti-coagulant,and/or anti-inflammatory activity. CB₂ receptor inhibitor compounds ofthe present inventio can be useful for the treatment of rheumatoidarthritis, systemic lupus erythematosus, multiple sclerosis, diabetes,osteoporosis, renal ischemia, cerebral stroke, cerebral ischemia,nephritis, inflammatory disorders of the lungs and gastrointestinaltract, and respiratory tract disorders such as reversible airwayobstruction, chronic asthma and bronchitis.

Compounds of the invention can be useful for the treatment ofthrombosis, atherosclerosis, restenosis, hypertension, angina pectoris,angiogenesis related disorders, arrhythmia, a cardiovascular orcirculatory disease or condition, heart failure, acute coronary syndrome(ACS), myocardial infarction, glomerulonephritis, thrombotic stroke,thromboembolytic stroke, peripheral vascular diseases, deep veinthrombosis, venous thromboembolism, a cardiovascular disease associatedwith hormone replacement therapy, disseminated intravascular coagulationsyndrome, cerebral infarction, migraine, erectile dysfunction,rheumatoid arthritis, rheumatism, astrogliosis, a fibrotic disorder ofthe liver, kidney, lung or intestinal tract, systemic lupuserythematosus, multiple sclerosis, osteoporosis, renal disease, acuterenal failure, chronic renal failure, renal vascular homeostasis, renalischemia, bladder inflammation, diabetes, diabetic neuropathy, cerebralstroke, cerebral ischemia, nephritis, cancer, melanoma, renal cellcarcinoma, neuropathy, malignant tumors, neurodegenerative and/orneurotoxic diseases, conditions or injuries, Alzheimer's disease, aninflammatory disease or condition, asthma, glaucoma, maculardegeneration, psoriasis, endothelial dysfunction disorders of the liver,kidney or lung, inflammatory disorders of the lungs and gastrointestinaltract, respiratory tract disease or condition, radiation fibrosis,endothelial dysfunction, periodontal diseases or wounds, or a spinalcord injury, or a symptom or result thereof, as well as other disordersin which thrombin and its receptor play a pathological role.

In particular, compounds of the present invention are used to treatacute coronary syndrome, myocardial infarction ot thrombotic stroke.

Compounds of the present invention can also be used in a method to treator prevent a condition associated with cardiopulmonary bypass surgery(CPB) comprising administering an effective amount of at least onethrombin receptor antagonist to a subject of said surgery. CPB surgeryincludes coronary artery bypass surgery (CABG), cardiac valvular repairand replacement surgery, pericardial and aortic repair surgeries. Inparticular, the present invention relates to a method of treating orpreventing a condition associated with CABG surgery comprisingadministering an effective amount of at least one thrombin receptorantagonist to a subject of said surgery. The conditions associated withCABG are selected from the group consisting of: bleeding; thromboticvascular events such as thrombosis, restenosis; vein graft failure;artery graft failure; atherosclerosis, angina pectoris; myocardialischemia; acute coronary syndrome myocardial infarction; heart failure;arrhythmia; hypertension; transient ischemic attack; cerebral functionimpairment; thromboembolic stroke; cerebral ischemia; cerebralinfarction; thrombophlebitis; deep vein thrombosis; and, peripheralvascular disease.

In another embodiment, compounds of the present invention are useful ina method for treating and/or preventing radiation- and/orchemical-induced toxicity in non-malignant tissue in a patientcomprising administering a therapeutically effective amount of acompound of formula I. In particular, the radiation- and/orchemical-induced toxicity is one or more of intestinal fibrosis,pneumonitis, and mucositis. In a preferred embodiment, the radiation-and/or chemical-induced toxicity is intestinal fibrosis. In anotherpreferred embodiment, the radiation- and/or chemical-induced toxicity isoral mucositis. In yet another embodiment, the radiation- and/orchemical-induced toxicity is intestinal mucositis, intestinal fibrosis,intestinal radiation syndrome, or pathophysiological manifestations ofintestinal radiation exposure.

The present invention also provides methods for reducing structuralradiation injury in a patient that will be exposed, is concurrentlyexposed, or was exposed to radiation and/or chemical toxicity,comprising administering a therapeutically effective amount of acompound of formula I. The present invention also provides methods forreducing inflammation in a patient that will be exposed, is concurrentlyexposed, or was exposed to radiation and/or chemical toxicity,comprising administering a therapeutically effective amount of acompound of formula I. The present invention also provides methods foradverse tissue remodeling in a patient that will be exposed, isconcurrently exposed, or was exposed to radiation and/or chemicaltoxicity, comprising administering a therapeutically effective amount ofa compound of formula I. The present invention also provides methods forreducing fibroproliferative tissue effects in a patient that will beexposed, is concurrently exposed, or was exposed to radiation and/orchemical toxicity, comprising administering a therapeutically effectiveamount of a compound of formula I.

The present invention further provides methods useful for treating acell proliferative disorder in a patient suffering therefrom comprisingadministering a therapeutically effective amount of a compound offormula I. In one embodiment, the cell proliferative disorder ispancreatic cancer, glioma, ovarian cancer, colorectal and/or coloncancer, breast cancer, prostate cancer, thyroid cancer, lung cancer,melanoma, or stomach cancer. In one embodiment, the glioma is ananaplastic astrocytoma. In another embodiment, the glioma is aglioblastoma multiforme.

As used above, the term inflammatory disease or condition includesirritable bowel syndrome, Crohn's disease, nephritis or a radiation- orchemotherapy-induced proliferative or inflammatory disorder of thegastrointestinal tract, lung, urinary bladder, gastrointestinal tract orother organ. The term respiratory tract disease or condition includesreversible airway obstruction, asthma, chronic asthma, bronchitis orchronic airways disease. “Cancer” includes renal cell carcinoma or anangiogenesis related disorder. “Neurodegenerative disease” includesParkinson's disease, amyotropic lateral sclerosis, Alzheimer's disease,Huntington's disease or Wilson's disease.

Certain embodiments of this invention also relate to a method of usingan effective amount of at least one compound of Formula I in combinationwith one or more additional agents for the treatment of thrombosis,atherosclerosis, restenosis, hypertension, angina pectoris, angiogenesisrelated disorders, arrhythmia, a cardiovascular or circulatory diseaseor condition, heart failure, acute coronary syndrome (ACS), myocardialinfarction, glomerulonephritis, thrombotic stroke, thromboembolyticstroke, peripheral vascular diseases, deep vein thrombosis, venousthromboembolism, a cardiovascular disease associated with hormonereplacement therapy, disseminated intravascular coagulation syndrome,cerebral infarction, migraine, erectile dysfunction, rheumatoidarthritis, rheumatism, astrogliosis, a fibrotic disorder of the liver,kidney, lung or intestinal tract, systemic lupus erythematosus, multiplesclerosis, osteoporosis, renal disease, acute renal failure, chronicrenal failure, renal vascular homeostasis, renal ischemia, bladderinflammation, diabetes, diabetic neuropathy, cerebral stroke, cerebralischemia, nephritis, cancer, melanoma, renal cell carcinoma, neuropathy,malignant tumors, neurodegenerative and/or neurotoxic diseases,conditions or injuries, Alzheimer's disease, an inflammatory disease orcondition, asthma, glaucoma, macular degeneration, psoriasis,endothelial dysfunction disorders of the liver, kidney or lung,inflammatory disorders of the lungs and gastrointestinal tract,respiratory tract disease or condition, radiation fibrosis, endothelialdysfunction, periodontal diseases or wounds, or a spinal cord injury, ora symptom or result thereof. It is contemplated that a combination ofthis invention may be useful in treating more than one of the diseaseslisted.

For treating and/or preventing radiation- and/or chemical-inducedtoxicity in non-malignant tissue, the present invention includesadministering to a patient in need of such treatment an effective amountof a combination of one or more compounds of formula I and one or moreradiation-response modifiers selected from the group consisting ofKepivance™ (palifermin), L-glutamine, teduglutide, sucralfate mouthrinses, iseganan, lactoferrin, mesna and trefoil factor.

For treating a cell proliferative disorder the present inventionincludes administering to a patient in need of such tretment aneffective amount of a combination of one or more compounds of formula Iand another antineoplastic agent. In one embodiment, the otherantineoplastic agent is temozolomide and the cell proliferative disorderis glioma. In another embodiment, the other antineoplastic agent isinterferon and the cell proliferative disorder is melanoma. In oneembodiment, the other antineoplastic agent is PEG-Intron (peginterferonalpha-2b) and the cell proliferative disorder is melanoma.

Pharmaceutical compositions comprising a therapeutically effectiveamount of a combination of at least one compound of formula I and atleast one additional cardiovascular agent in a pharmaceuticallyacceptable carrier are also provided.

Pharmaceutical compositions comprising a therapeutically effectiveamount of a combination of at least one compound of formula I and aradiation-response modifier in a pharmaceutically acceptable carrier arealso provided.

Pharmaceutical compositions comprising a therapeutically effectiveamount of a combination of at least one compound of formula I and anantineoplastic agent in a pharmaceutically acceptable carrier are alsoprovided.

It is further contemplated that the combination of the invention can beprovided as a kit comprising in a single package at least one compoundof formula I in a pharmaceutical composition, and at least one separatepharmaceutical composition comprising a cardiovascular agent, aradiation-response modifier, or an antineoplastic agent.

DETAILED DESCRIPTION

In one embodiment, the present invention provides compounds representedby structural formula I, or pharmaceutically acceptable salt thereof,wherein the various moieties are as described as above.

For compounds of Formula I, preferred embodiments of the compounds offormula I are as follows:

Additional preferred embodiments of the compounds of formula I are asfollows:

In one embodiment of a compound of formula I, wherein E is NR⁵⁴.

An embodiment of a compound of formula I, wherein E is —C(O)—.

Another embodiment of a compound of formula I, wherein A is —C(R¹R²)—.

Another embodiment of a compound of formula I, wherein A is —S(O)₂—.

Another embodiment of a compound of formula I, wherein A is C(O).

Another embodiment of a compound of formula I, wherein A and M are eachindependently CH₂.

Another embodiment of a compound of formula I, wherein n of A_(n) andM_(n) is 0, 1 or 2.

An embodiment of a compound of formula I, wherein G or U is N.

Another embodiment of a compound of formula I, wherein R³² and R³³ arecombined to form the ring structure Q.

Another embodiment of a compound of formula I, wherein A is N and E isO.

Another embodiment of a compound of formula I, wherein A is O and E isN.

Another embodiment of a compound of formula I, wherein A_(n) is—C(R¹R²)—, —C(O)— or S(O)₂, E is —C(O)— or NR⁵⁴; M_(n) is —CH₂—; n, forA_(n) and M_(n), is 0, 1 or 2; and R³² and R³³ are combined to form aring structure Q.

Another embodiment of a compound of formula I, wherein A_(n) is—C(R¹R²)—, —C(O)— or S(O)₂;

E is —C(O)— or NR⁵⁴;

M_(n) is —CH₂—; and

n, for A_(n) and M_(n), is 0, 1 or 2.

Another embodiment of a compound of formula I, wherein B is—(CH₂)_(n4)CR¹²═CR^(12a)(CH₂)_(n5)— wherein n₄ and n₅ are 0.

Another embodiment of a compound of formula I, wherein Q is

Another embodiment of a compound of formula I, wherein W is aryl,heteroaryl or aryl substituted by halogen or —CN.

An additional embodiment of a compound of formula I, wherein W is arylsubstituted with halogen.

An additional embodiment of a compound of formula I, wherein W is

An additional embodiment of a compound of formula I, wherein K_(n) is—CH(CH₂CH₃)— and n is 1

An additional embodiment of a compound of formula I, wherein thefollowing ring portion of the compound of formula I,

An additional embodiment of a compound of formula I, wherein J_(n) is—CH₂— where n is 1.

An additional embodiment of a compound of formula I, wherein R⁹, R¹⁰ andR¹¹ are H.

An additional embodiment of a compound of formula I, wherein thefollowing ring portion of the compound of formula I,

W is

B is —(CH₂)_(n4)CR¹²═CR^(12a)(CH₂)_(n5)— wherein n₄ and n₅ are 0;

J_(n) is —CH₂— where n is 1; and

R⁹, R¹⁰ and R¹¹ are H.

Another embodiment of a compound of formula I, a compound of thefollowing structure

As used above, and throughout this disclosure, the following terms,unless otherwise indicated, shall be understood to have the followingmeanings:

“Patient” includes both human and animals.

“Subject” includes both mammals and non-mammalian animals.

“Mammal” means humans and other mammalian animals.

The following definitions apply regardless of whether a term is used byitself or in combination with other terms, unless otherwise indicated.Therefore, the definition of “alkyl” applies to “alkyl” as well as the“alkyl” portions of “hydroxyalkyl”, “haloalkyl”, “alkoxy”, etc.

“Alkyl” means an aliphatic hydrocarbon group which may be straight orbranched and comprising about 1 to about 20 carbon atoms in the chain.Preferred alkyl groups contain about 1 to about 12 carbon atoms in thechain. More preferred alkyl groups contain about 1 to about 6 carbonatoms in the chain. Branched means that one or more lower alkyl groupssuch as methyl, ethyl or propyl, are attached to a linear alkyl chain.“Lower alkyl” means a group having about 1 to about 6 carbon atoms inthe chain which may be straight or branched. The term “substitutedalkyl” means that the alkyl group may be substituted by one or moresubstituents which may be the same or different, each substituent beingindependently selected from the group consisting of halo, alkyl, aryl,cycloalkyl, cyano, hydroxy, alkoxy, alkylthio, amino, —NH(alkyl),—NH(cycloalkyl), —N(alkyl)₂, carboxy and —C(O)O-alkyl. Non-limitingexamples of suitable alkyl groups include methyl, ethyl, n-propyl,isopropyl, n-butyl, t-butyl, n-pentyl, heptyl, nonyl, decyl,fluoromethyl, trifluoromethyl and cyclopropylmethyl.

“Aralkyl” or “arylalkyl” means an aryl-alkyl- group in which the aryland alkyl are as previously described. Preferred aralkyls comprise alower alkyl group. Non-limiting examples of suitable aralkyl groupsinclude benzyl, 2-phenethyl and naphthalenylmethyl. The bond to theparent moiety is through the alkyl.

“Alkylaryl” means an alkyl-aryl- group in which the alkyl and aryl areas previously described. Preferred alkylaryls comprise a lower alkylgroup. Non-limiting example of a suitable alkylaryl group is tolyl. Thebond to the parent moiety is through the aryl.

“Alkenyl” means an aliphatic hydrocarbon group (straight or branchedcarbon chain) comprising one or more double bonds in the chain and whichcan be conjugated or unconjugated. Useful alkenyl groups can comprise 2to about 15 carbon atoms in the chain, preferably 2 to about 12 carbonatoms in the chain, and more preferably 2 to about 6 carbon atoms in thechain. The alkenyl group can be substituted by one or more substituentsindependently selected from the group consisting of halo, alkyl, aryl,cycloalkyl, cyano and alkoxy. Non-limiting examples of suitable alkenylgroups include ethenyl, propenyl, n-butenyl, 3-methylbut-enyl andn-pentenyl.

Where an alkyl or alkenyl chain joins two other variables and istherefore bivalent, the terms alkylene and alkenylene, respectively, areused.

“Alkynyl” means an aliphatic hydrocarbon group containing at least onecarbon-carbon triple bond and which may be straight or branched andcomprising about 2 to about 15 carbon atoms in the chain. Preferredalkynyl groups have about 2 to about 12 carbon atoms in the chain; andmore preferably about 2 to about 4 carbon atoms in the chain. Branchedmeans that one or more lower alkyl groups such as methyl, ethyl orpropyl, are attached to a linear alkynyl chain. “Lower alkynyl” meansabout 2 to about 6 carbon atoms in the chain which may be straight orbranched. Non-limiting examples of suitable alkynyl groups includeethynyl, propynyl, 2-butynyl, 3-methylbutynyl, n-pentynyl, and decynyl.The term “substituted alkynyl” means that the alkynyl group may besubstituted by one or more substituents which may be the same ordifferent, each substituent being independently selected from the groupconsisting of alkyl, aryl and cycloalkyl.

“Aryl” means an aromatic monocyclic or multicyclic ring systemcomprising about 6 to about 14 carbon atoms, preferably about 6 to about10 carbon atoms. The aryl group can be optionally substituted with oneor more “ring system substituents” which may be the same or different,and are as defined herein. Non-limiting examples of suitable aryl groupsinclude phenyl, naphthyl, indenyl, tetrahydronaphthyl and indanyl.“Arylene” means a bivalent phenyl group, including ortho, meta andpara-substitution.

“Ring system substituent” means a substituent attached to an aromatic ornon-aromatic ring system which, for example, replaces an availablehydrogen on the ring system. Ring system substituents may be the same ordifferent, each being independently selected from the group consistingof alkyl, alkenyl, alkynyl, aryl, heteroaryl, aralkyl, alkylaryl,heteroaralkyl, heteroarylalkenyl, heteroarylalkynyl, alkylheteroaryl,hydroxy, hydroxyalkyl, alkoxy, aryloxy, aralkoxy, acyl, aroyl, halo,nitro, cyano, carboxy, alkoxycarbonyl, aryloxycarbonyl,aralkoxycarbonyl, alkylsulfonyl, arylsulfonyl, heteroarylsulfonyl,alkylthio, arylthio, heteroarylthio, aralkylthio, heteroaralkylthio,cycloalkyl, heterocyclyl, —C(═N—CN)—NH₂, —C(═NH)—NH₂, —C(═NH)—NH(alkyl),Y₁Y₂N—, Y₁Y₂N-alkyl-, Y₁Y₂NC(O)—, Y₁Y₂NSO₂— and —SO₂NY₁Y₂, wherein Y₁and Y₂ can be the same or different and are independently selected fromthe group consisting of hydrogen, alkyl, aryl, cycloalkyl, and aralkyl.“Ring system substituent” may also mean a single moiety whichsimultaneously replaces two available hydrogens on two adjacent carbonatoms (one H on each carbon) on a ring system. Examples of such moietyare methylene dioxy, ethylenedioxy, —C(CH₃)₂— and the like which formmoieties such as, for example:

The term “Boc” refers to N-tert-butoxycarbonyl.

“Cycloalkyl” means a non-aromatic mono- or multicyclic ring systemcomprising about 3 to about 10 carbon atoms, preferably about 5 to about10 carbon atoms. Preferred cycloalkyl rings contain about 5 to about 7ring atoms. The cycloalkyl can be optionally substituted with one ormore “ring system substituents” which may be the same or different, andare as defined above. Non-limiting examples of suitable monocycliccycloalkyls include cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl,cycloheptyl and the like. Non-limiting examples of suitable multicycliccycloalkyls include 1-decalinyl, norbornyl, adamantyl and the like, aswell as partially saturated species such as, for example, indanyl,tetrahydronaphthyl and the like.

“Cycloalkenyl” means a non-aromatic mono or multicyclic ring systemcomprising about 3 to about 10 carbon atoms, preferably about 5 to about10 carbon atoms which contains at least one carbon-carbon double bond.Preferred cycloalkenyl rings contain about 5 to about 7 ring atoms. Thecycloalkenyl can be optionally substituted with one or more “ring systemsubstituents” which may be the same or different, and are as definedabove. Non-limiting examples of suitable monocyclic cycloalkenylsinclude cyclopentenyl, cyclohexenyl, cycloheptenyl, and the like.Non-limiting example of a suitable multicyclic cycloalkenyl isnorbornylenyl.

“Cycloalkylene” refers to a corresponding bivalent ring, wherein thepoints of attachment to other groups include all positional isomers.

“Dihydroxyalkyl” refers to an alkyl chain substituted by two hydroxygroups on two different carbon atoms.

“Fluoroalkyl”, “difluoroalkyl” and “trifluoroalkyl” mean alkyl chainswherein the terminal carbon is substituted by 1, 2 or 3 fluoroatoms,respectively, e.g., —CF₃, —CH₂CF₃, —CH₂CHF₂ or —CH₂CH₂F.

“Halo” refers to fluorine, chlorine, bromine or iodine radicals.Preferred are fluoro, chloro or bromo, and more preferred are fluoro andchloro.

“Halogen” means fluorine, chlorine, bromine, or iodine. Preferred arefluorine, chlorine and bromine.

“Heteroaryl” means an aromatic monocyclic or multicyclic ring systemcomprising about 5 to about 14 ring atoms, preferably about 5 to about10 ring atoms, in which one or more of the ring atoms is an elementother than carbon, for example nitrogen, oxygen or sulfur, alone or incombination, provided that the rings do not include adjacent oxygenand/or sulfur atoms. N-oxides of the ring nitrogens are also included,as well as compounds wherein a ring nitrogen is substituted by an alkylgroup to form a quaternary amine. Preferred heteroaryls contain about 5to about 6 ring atoms. The “heteroaryl” can be optionally substituted byone or more “ring system substituents” which may be the same ordifferent, and are as defined herein. The prefix aza, oxa or thia beforethe heteroaryl root name means that at least a nitrogen, oxygen orsulfur atom respectively, is present as a ring atom. A nitrogen atom ofa heteroaryl can be optionally oxidized to the corresponding N-oxide.Non-limiting examples of suitable heteroaryls include pyridyl,pyrazinyl, furanyl, thienyl, pyrimidinyl, pyridone (includingN-substituted pyridones), isoxazolyl, isothiazolyl, oxazolyl, thiazolyl,pyrazolyl, oxadiazolyl, tetrazolyl, pyrimidyl, furazanyl, pyrrolyl,pyrazolyl, triazolyl, 1,2,4-thiadiazolyl, pyrazinyl, pyridazinyl,quinoxalinyl, phthalazinyl, oxindolyl, naphthyridyl (e.g., 1, 5 or 1,7),pyrido[2,3]imidazolyl, imidazo[1,2-a]pyridinyl, imidazo[2,1-b]thiazolyl,benzofuranyl, benzofurazanyl, indolyl, azaindolyl, benzimidazolyl,benzothienyl, quinolinyl, imidazolyl, thienopyridyl, quinazolinyl,thienopyrimidyl, pyrrolopyridyl, imidazopyridyl, isoquinolinyl,benzoazaindolyl, 1,2,4-triazinyl, benzoxazolyl, benzothiazolyl,pyridopyrimidinyl, 7-azaindolyl and the like. The term “heteroaryl” alsorefers to partially saturated heteroaryl moieties such as, for example,tetrahydroisoquinolyl, tetrahydroquinolyl and the like. All positionalisomers are contemplated, e.g., 2-pyridyl, 3-pyridyl and 4-pyridyl.

The term “Het” is exemplified by the single ring, bicyclic andbenzofused heteroaryl groups as defined immediately above. Het groupsare joined to group B by a carbon ring member, e.g., Het is 2-pyridyl,3-pyridyl or 2-quinolyl. The Het ring can be substituted on anyavailable ring carbon by a group W; 1 to 4 W substituents can be presenton a Het ring.

“Heterocyclyl” or “heterocycloalkyl” means a non-aromatic saturatedmonocyclic or multicyclic ring system comprising about 3 to about 10ring atoms, preferably about 5 to about 10 ring atoms, in which one ormore of the atoms in the ring system is an element other than carbon,for example nitrogen, oxygen or sulfur, alone or in combination. Thereare no adjacent oxygen and/or sulfur atoms present in the ring system.Preferred heterocyclyls contain about 5 to about 6 ring atoms. Theprefix aza, oxa or thia before the heterocyclyl root name means that atleast a nitrogen, oxygen or sulfur atom respectively is present as aring atom. Any —NH in a heterocyclyl ring may exist protected such as,for example, as an —N(Boc), —N(CBz), —N(Tos) group and the like; suchprotections are also considered part of this invention. The heterocyclylcan be optionally substituted by one or more “ring system substituents”which may be the same or different, and are as defined herein. Thenitrogen or sulfur atom of the heterocyclyl can be optionally oxidizedto the corresponding N-oxide, S-oxide or S,S-dioxide. Non-limitingexamples of suitable monocyclic heterocyclyl rings include piperidyl,pyrrolidinyl, piperazinyl, morpholinyl, thiomorpholinyl, thiazolidinyl,1,3-dioxanyl, 1,4-dioxanyl, tetrahydrofuranyl, tetrahydrothiopyranyl,tetrahydrothiophenyl, lactam, lactone, and the like.

It should be noted that in hetero-atom containing ring systems of thisinvention, there are no hydroxyl groups on carbon atoms adjacent to a N,O or S, as well as there are no N or S groups on carbon adjacent toanother heteroatom. Thus, for example, in the ring:

there is no —OH attached directly to carbons marked 2 and 5.

It should also be noted that tautomeric forms such as, for example, themoieties:

are considered equivalent in certain embodiments of this invention.

The term “heterospirocyclic” refers to a spirocyclic structurecontaining 3 to 5 carbon atoms and 1 or 2 heteroatoms selected from thegroup consisting of N, S and O, provided that the heteroatoms are notadjacent.

“Alkylamino” means an alkyl-amino group in which the alkyl group is aspreviously described. The bond to the parent moiety is through theamino.

“Alkylaminoalkyl” means an alkyl-amino-alkyl group in which the alkylgroups are as previously described. The bond to the parent moiety isthrough the alkyl.

“Alkylcycloalkylalkyl” means an alkyl-cycloalkyl-alkyl group in whichthe alkyl and cycloalkyl groups are as previously described. The bond tothe parent moiety is through the alkyl.

“Alkylheteroaryl” means an alkyl-heteroaryl group in which the alkyl andheteroaryl groups are as previously described. The bond to the parentmoiety is through the heteroaryl.

“Alkylheterocycloalkyl” means an alkyl-heterocycloalkyl group in whichthe alkyl and heterocycloalkyl groups are as previously described. Thebond to the parent moiety is through the heterocycloalkyl group.

“Alkoxyalkyloxyalkyl” means an alkoxy-alkyl-O-alkyl group in which thealkoxy and alkyl groups are as previously described. The bond to theparent moiety is through the alkyl group.

“Alkynylalkyl” means an alkynyl-alkyl- group in which the alkynyl andalkyl are as previously described. Preferred alkynylalkyls contain alower alkynyl and a lower alkyl group. The bond to the parent moiety isthrough the alkyl. Non-limiting examples of suitable alkynylalkyl groupsinclude propargylmethyl.

“Haloalkyl” means a halo-alkyl- group in which the alkyl group is aspreviously described. The bond to the parent moiety is through thealkyl. Non-limiting examples of suitable haloalkyl groups includefluoromethyl and difluoromethyl.

“Heteroaralkyl” or “heteroarylalkyl” means a heteroaryl-alkyl- group inwhich the heteroaryl and alkyl are as previously described. Preferredheteroaralkyls contain a lower alkyl group. Non-limiting examples ofsuitable aralkyl groups include pyridylmethyl, and quinolin-3-ylmethyl.The bond to the parent moiety is through the alkyl.

“Heteroarylalkenyl” means a heteroaryl-alkenyl group in which theheteroaryl and alkenyl are as previously described. Preferredheteroarylalkenyl contain a lower alkenyl group. The bond to the parentmoiety is through the alkenyl group.

“Heterocyclylalkyl” or “heterocycloalkylalkyl” means aheterocyclyl-alkyl group in which the heterocyclyl and alkyl groups areas previously described. The bond to the parent moiety is through thealkyl group.

“Heterocycloalkyloxy” means a heterocycloalkyl-O— group in which theheterocycloalkyl group is as previously described. The bond to theparent moiety is through the ether atom.

“Heteroarylalkoxyalkyl” means a heteroaryl-alkoxyalkyl group in whichthe heteroaryl and alkoxyalkyl groups are as described above. The bondto the parent moiety is through the alkyl group.

“Hydroxyalkyl” means a HO-alkyl- group in which alkyl is as previouslydefined. Preferred hydroxyalkyls contain lower alkyl. Non-limitingexamples of suitable hydroxyalkyl groups include hydroxymethyl and2-hydroxyethyl.

“Acyl” means an H—C(O)—, alkyl-C(O)— or cycloalkyl-C(O)—, group in whichthe various groups are as previously described. The bond to the parentmoiety is through the carbonyl. Preferred acyls contain a lower alkyl.Non-limiting examples of suitable acyl groups include formyl, acetyl andpropanoyl.

“Aminoalkyl” means an amino-alkyl group in which the alkyl group is aspreviously described. The bond to the parent moiety is through thealkyl.

“Aroyl” means an aryl-C(O)— group in which the aryl group is aspreviously described. The bond to the parent moiety is through thecarbonyl. Non-limiting examples of suitable groups include benzoyl and1-naphthoyl.

“Alkenyloxy” means an alkenyl-O— group in which the alkenyl group is aspreviously described. The bond to the parent moiety is through the etheroxygen.

“Alkynyloxy” means an alkynyl-O— group in which the alkenyl group is aspreviously described. The bond to the parent moiety is through the etheroxygen.

“Alkoxy” means an alkyl-O— group in which the alkyl group is aspreviously described. Non-limiting examples of suitable alkoxy groupsinclude methoxy, ethoxy, n-propoxy, isopropoxy and n-butoxy. The bond tothe parent moiety is through the ether oxygen.

“Aralkoxy” or “arylalkoxy” means an aralkyl-O— group in which thearalkyl group is as previously described. The bond to the parent moietyis through the oxygen atom.

“Alkoxyalkyl” or “alkyloxyalkyl” means an alkyl-O-alkyl group in whichthe alkyl and alkyl groups are as previously described. Non-limitingexamples of suitable alkyloxyalkyl groups include methoxymethyl andethoxymethyl. The bond to the parent moiety is through the alkyl group.

“Aryloxy” means an aryl-O— group in which the aryl group is aspreviously described. Non-limiting examples of suitable aryloxy groupsinclude phenoxy and naphthoxy. The bond to the parent moiety is throughthe ether oxygen.

“Aryloxyalkyl” means an aryl-O-alkyl group in which the aryl and alkylgroups are as previously described. Non-limiting examples of suitablearyloxyalkyl groups include phenoxymethyl and naphthoxymethyl. The bondto the parent moiety is through the alkyl group.

“Arylalkoxyalkyl” means an aryl-alkoxyalkyl group in which the aryl andalkoxyalkyl groups are as previously described. The bond to the parentmoiety is through the alkyl group.

“Aralkyloxy” means an aralkyl-O— group in which the aralkyl group is aspreviously described. Non-limiting examples of suitable aralkyloxygroups include benzyloxy and 1- or 2-naphthalenemethoxy. The bond to theparent moiety is through the ether oxygen.

“Arylalkenyl” means an aryl-alkenyl- group in which the aryl and alkenylgroups are as previously described. The bond to the parent moiety isthrough the alkenyl.

“Alkylthio” means an alkyl-S— group in which the alkyl group is aspreviously described. Non-limiting examples of suitable alkylthio groupsinclude methylthio and ethylthio. The bond to the parent moiety isthrough the sulfur.

“Arylthio” means an aryl-S— group in which the aryl group is aspreviously described. Non-limiting examples of suitable arylthio groupsinclude phenylthio and naphthylthio. The bond to the parent moiety isthrough the sulfur.

“Aralkylthio” means an aralkyl-S— group in which the aralkyl group is aspreviously described. Non-limiting example of a suitable aralkylthiogroup is benzylthio. The bond to the parent moiety is through thesulfur.

“Alkoxycarbonyl” means an alkyl-O—CO— group. Non-limiting examples ofsuitable alkoxycarbonyl groups include methoxycarbonyl andethoxycarbonyl. The bond to the parent moiety is through the carbonyl.

“Aryloxycarbonyl” means an aryl-O—C(O)— group. Non-limiting examples ofsuitable aryloxycarbonyl groups include phenoxycarbonyl andnaphthoxycarbonyl. The bond to the parent moiety is through thecarbonyl.

“Aralkoxycarbonyl” means an aralkyl-O—C(O)— group. Non-limiting exampleof a suitable aralkoxycarbonyl group is benzyloxycarbonyl. The bond tothe parent moiety is through the carbonyl.

“Alkylsulfonyl” means an alkyl-S(O₂)— group. Preferred groups are thosein which the alkyl group is lower alkyl. The bond to the parent moietyis through the sulfonyl.

“Arylsulfonyl” means an aryl-S(O₂)— group. The bond to the parent moietyis through the sulfonyl.

“Cycloalkenyloxy” means a cycloalkenyl-O— group in which thecycloalkenyl group is as previously described. The bond to the parentmoiety is through the ether atom.

“Cycloalkylyalkyl” means a cycloalkyl-alkyl group in which thecycloalkyl and alkyl groups are as previously described. The bond to theparent moiety is through the alkyl group.

“Cycloalkyloxy” or “cycloalkoxy” means a cycloalkyl-O— group in whichthe cycloalkyl group is as previously described. The bond to the parentmoiety is through the ether atom.

“Cycloalkyloxyalkyl” means a cycloalkyl-O-alkyl group in which thecycloalkyl and alkyl groups are as previously described. The bond to theparent moiety is through the alkyl group.

“Haloalkoxyalkyl” means a halo alkoxyalkyl group in which thealkoxyalkyl group is as previously described. The bond to the parentmoiety is through the alkyl group.

“Heterocyclylalkoxyalkyl” means a heterocyclyl-alkoxyalkyl group inwhich the alkoxyalkyl group is as previously described. The bond to theparent moiety is through the alkyl group.

The optional double bond represented by

means that at least a single bond must be present, but that a doublebond can be present; when the double bond is present, R¹⁰ is absent.

When R⁴ and R⁵ join to form a ring with the nitrogen to which they areattached, the rings formed are 1-pyrrolidinyl, 1-piperidinyl and1-piperazinyl, wherein the piperazinyl ring may also be substituted atthe 4-position nitrogen by a group R⁷.

The above statements, wherein, for example, R⁴ and R⁵ are said to beindependently selected from a group of substituents, means that R⁴ andR⁵ are independently selected when attached to the same nitrogen, butalso that where an R⁴ or R⁵ variable occurs more than once in amolecule, those occurrences are independently selected. Similarly, eachoccurrence of R¹³ or R¹⁴ is independent of any other R¹³ or R¹⁴ in thesame Q ring. Those skilled in the art will recognize that the size andnature of the substituent(s) will affect the number of substituentswhich can be present.

The term “substituted” means that one or more hydrogens on thedesignated atom is replaced with a selection from the indicated group,provided that the designated atom's normal valency under the existingcircumstances is not exceeded, and that the substitution results in astable compound. Combinations of substituents and/or variables arepermissible only if such combinations result in stable compounds. By“stable compound’ or “stable structure” is meant a compound that issufficiently robust to survive isolation to a useful degree of purityfrom a reaction mixture, and formulation into an efficacious therapeuticagent.

The term “optionally substituted” means optional substitution with thespecified groups, radicals or moieties.

The term “isolated” or “in isolated form” for a compound refers to thephysical state of said compound after being isolated from a syntheticprocess or natural source or combination thereof. The term “purified” or“in purified form” for a compound refers to the physical state of saidcompound after being obtained from a purification process or processesdescribed herein or well known to the skilled artisan, in sufficientpurity to be characterizable by standard analytical techniques describedherein or well known to the skilled artisan.

The structure

in the compound of formula I, represents an optional double bond, thedotted line is a bond or no bond, resulting in a double bond or a singlebond, as permitted by the valency requirement; with the proviso that R³is absent when the carbon to which R³ would be attached is part of adouble bond.

It should also be noted that any carbon as well as heteroatom withunsatisfied valences in the text, schemes, examples and Tables herein isassumed to have the sufficient number of hydrogen atom(s) to satisfy thevalences.

When a functional group in a compound is termed “protected”, this meansthat the group is in modified form to preclude undesired side reactionsat the protected site when the compound is subjected to a reaction.Suitable protecting groups will be recognized by those with ordinaryskill in the art as well as by reference to standard textbooks such as,for example, T. W. Greene et al, Protective Groups in organic Synthesis(1991), Wiley, New York.

When any variable (e.g., aryl, heterocycle, R², etc.) occurs more thanone time in any constituent or in Formula I, its definition on eachoccurrence is independent of its definition at every other occurrence.

As used herein, the term “composition” is intended to encompass aproduct comprising the specified ingredients in the specified amounts,as well as any product which results, directly or indirectly, fromcombination of the specified ingredients in the specified amounts.

Prodrugs, solvates and co-crystals of the compounds of the invention arealso contemplated herein. The term “prodrug”, as employed herein,denotes a compound that is a drug precursor which, upon administrationto a subject, undergoes chemical conversion by metabolic or chemicalprocesses to yield a compound of Formula I or a salt and/or solvatethereof. A discussion of prodrugs is provided in T. Higuchi and V.Stella, Pro-drugs as Novel Delivery Systems (1987) 14 of the A.C.S.Symposium Series, and in Bioreversible Carriers in Drug Design, (1987)Edward B. Roche, ed., American Pharmaceutical Association and PergamonPress, both of which are incorporated herein by reference thereto.

“Solvate” means a physical association of a compound of this inventionwith one or more solvent molecules. This physical association involvesvarying degrees of ionic and covalent bonding, including hydrogenbonding. In certain instances the solvate will be capable of isolation,for example when one or more solvent molecules are incorporated in thecrystal lattice of the crystalline solid. “Solvate” encompasses bothsolution-phase and isolatable solvates. Non-limiting examples ofsuitable solvates include ethanolates, methanolates, and the like.“Hydrate” is a solvate wherein the solvent molecule is H₂O.

A co-crystal is a crystalline superstructure formed by combining anactive pharmaceutical intermediate with an inert molecule that producescrystallinity to the combined form. Co-crystals are often made between adicarboxlyic acid such as fumaric acid, succinic acid etc. and a basicamine such as the one represented by compound I of this invention indifferent proportions depending on the nature of the co-crystal.(Rmenar, J. F. et. al. J Am. Chem. Soc. 2003, 125, 8456).

“Effective amount” or “therapeutically effective amount” is meant todescribe an amount of compound or a composition of the present inventioneffective as thrombin receptor antagonists and thus producing thedesired therapeutic, ameliorative, inhibitory or preventative effect.

The compounds of Formula I can form salts which are also within thescope of this invention. Reference to a compound of Formula I herein isunderstood to include reference to salts thereof, unless otherwiseindicated. The term “salt(s)”, as employed herein, denotes acidic saltsformed with inorganic and/or organic acids, as well as basic saltsformed with inorganic and/or organic bases. In addition, when a compoundof Formula I contains both a basic moiety, such as, but not limited to apyridine or imidazole, and an acidic moiety, such as, but not limited toa carboxylic acid, zwitterions (“inner salts”) may be formed and areincluded within the term “salt(s)” as used herein. Pharmaceuticallyacceptable (i.e., non-toxic, physiologically acceptable) salts arepreferred, although other salts are also useful. Salts of the compoundsof the Formula I may be formed, for example, by reacting a compound ofFormula I with an amount of acid or base, such as an equivalent amount,in a medium such as one in which the salt precipitates or in an aqueousmedium followed by lyophilization.

Exemplary acid addition salts include acetates, ascorbates, benzoates,benzenesulfonates, bisulfates, borates, butyrates, citrates,camphorates, camphorsulfonates, fumarates, hydrochlorides,hydrobromides, hydroiodides, lactates, maleates, methanesulfonates,naphthalenesulfonates, nitrates, oxalates, phosphates, propionates,salicylates, succinates, sulfates, tartarates, thiocyanates,toluenesulfonates (also known as tosylates,) and the like. Additionally,acids which are generally considered suitable for the formation ofpharmaceutically useful salts from basic pharmaceutical compounds arediscussed, for example, by P. Stahl et al, Camille G. (eds.) Handbook ofPharmaceutical Salts. Properties, Selection and Use. (2002) Zurich:Wiley-VCH; S. Berge et al, Journal of Pharmaceutical Sciences (1977)66(1) 1-19; P. Gould, International J. of Pharmaceutics (1986) 33201-217; Anderson et al, The Practice of Medicinal Chemistry (1996),Academic Press, New York; and in The Orange Book (Food & DrugAdministration, Washington, D.C. on their website). These disclosuresare incorporated herein by reference thereto.

Exemplary basic salts include ammonium salts, alkali metal salts such assodium, lithium, and potassium salts, alkaline earth metal salts such ascalcium and magnesium salts, salts with organic bases (for example,organic amines) such as dicyclohexylamines, t-butyl amines, and saltswith amino acids such as arginine, lysine and the like. Basicnitrogen-containing groups may be quarternized with agents such as loweralkyl halides (e.g. methyl, ethyl, and butyl chlorides, bromides andiodides), dialkyl sulfates (e.g. dimethyl, diethyl, and dibutylsulfates), long chain halides (e.g. decyl, lauryl, and stearylchlorides, bromides and iodides), aralkyl halides (e.g. benzyl andphenethyl bromides), and others.

All such acid salts and base salts are intended to be pharmaceuticallyacceptable salts within the scope of the invention and all acid and basesalts are considered equivalent to the free forms of the correspondingcompounds for purposes of the invention.

Compounds of Formula I, and salts, solvates, co-crystals and prodrugsthereof, may exist in their tautomeric form (for example, as an amide orimino ether). All such tautomeric forms are contemplated herein as partof the present invention.

All stereoisomers (for example, geometric isomers, optical isomers andthe like) of the present compounds (including those of the salts,solvates, co-crystals and prodrugs of the compounds as well as the saltsand solvates, co-crystals of the prodrugs), such as those which mayexist due to asymmetric carbons on various substituents, includingenantiomeric forms (which may exist even in the absence of asymmetriccarbons), rotameric forms, atropisomers, and diastereomeric forms, arecontemplated within the scope of this invention, as are positionalisomers (such as, for example, 4-pyridyl and 3-pyridyl). Individualstereoisomers of the compounds of the invention may, for example, besubstantially free of other isomers, or may be admixed, for example, asracemates or with all other, or other selected, stereoisomers. Thechiral centers of the present invention can have the S or Rconfiguration as defined by the IUPAC 1974 Recommendations. The use ofthe terms “salt”, “solvate” “prodrug” and the like, is intended toequally apply to the salt, solvate and prodrug of enantiomers,stereoisomers, rotamers, tautomers, positional isomers, racemates orprodrugs of the inventive compounds.

Polymorphic forms of the compounds of Formula I, and of the salts,solvates, co-crystals and prodrugs of the compounds of Formula I, areintended to be included in the present invention.

The compounds according to the invention have pharmacologicalproperties; in particular, the compounds of Formula I can be nor-secohimbacine derivatives useful as thrombin receptor antagonists.

Compounds of the invention have at least one asymmetrical carbon atomand therefore all isomers, including enantiomers, stereoisomers,rotamers, tautomers and racemates of the compounds of Formula (I) (wherethey exist) are contemplated as being part of this invention. Theinvention includes d and I isomers in both pure form and in admixture,including racemic mixtures. Isomers can be prepared using conventionaltechniques, either by reacting optically pure or optically enrichedstarting materials or by separating isomers of a compound of Formula I.Isomers may also include geometric isomers, e.g., when a double bond ispresent. Polymorphous forms of the compounds of Formula (I), whethercrystalline or amorphous, also are contemplated as being part of thisinvention.

Those skilled in the art will appreciate that for some of the compoundsof Formula I, one isomer will show greater pharmacological activity thanother isomers.

Typical preferred compounds of the present invention have the followingstereochemistry:

with compounds having that absolute stereochemistry being morepreferred.

Those skilled in the art will appreciate that for some compounds ofFormula I, one isomer will show greater pharmacological activity thanother isomers.

Compounds of the present invention in which are generally prepared byprocesses in accordance with the following.

Some of the following below compounds, intermediates and processes, canbe practiced by the methods as disclosed in any of U.S. Pat. No.6,063,847, U.S. Pat. No. 6,326,380, U.S. Pat. No. 6,645,987, U.S. Ser.No. 10/271715, all of which are incorporated herein by reference

Following are examples of preparing starting materials and compounds offormula I. In the procedures, the following abbreviations are used:

-   -   rt room temperature    -   THF tetrahydrofuran    -   Et₂O ethyl ether    -   Me methyl    -   Et ethyl    -   EtOAc ethyl acetate    -   BnOCH₂Cl benzylchloromethylether    -   BuLi Butyl Lithium    -   DBAD Di-tert-butyl azodicarboxylate    -   DCE 1,2-dichloroethane    -   DCM Dichloromethane    -   DMF N,N-Dimethylformamide    -   DMSO Methyl sulfoxide    -   HOBT or HOBt Hydroxybezotriazole    -   KHMDS Potassium bis(trimethylsilyl)amide    -   LiHMDS or LHMDS:Lithium bis(trimethylsilyl)amide    -   NaB(O₂CCH₃)₃H Sodium triacetoxyborohydride    -   PhSeBr Phenyl selenium bromide    -   PS Polymer supported    -   PS-EDC Polymer supported dimethyl aminopropyl ethylcarbodiimide        hydrochloride    -   PS-NCO Polymer supported isocyanate    -   PS-Tris-NH₂ Polymer supported trisamine    -   TFA Trifluoroacetic acid    -   Ti(OiPr)₄ titanium isopropoxide;    -   TLC thin layer chromatography    -   TMSI Trimethylsilyl iodide or iodotrimethylsilane

EXPERIMENTAL EXAMPLES

The synthesis of the targets described in this invention starts with thetricyclic carboxaldehyde 2 described in U.S. Pat. No. 6,063,847. Note,that starting with a nor-seco himbacine type compound as described in WO01/96330 and using similar chemistry, other embodiments of the claimedinvention can be derived. The aldehydes (for example, compound 2described herein below) was converted to an olefin (see compound 3described herein below) by Wittig reaction. LiAlH₄-mediated ring openingfollowed by selective TIPS protection of the primary alcohol wasfollowed by oxidation of the secondary alcohol to provide a ketone (forexample, a methyl ketone 4 herein described below). Deoxygenation of theketone along with removal of the TIPS ether gave as exemplified bycompound 5 below. The alcohol was protected as the acetate and subjectedto ozonolysis condition to provide an aldehyde (for example, compound6). This aldehyde was converted to an alkene (example, compound 8) underEmmons-Wadsworth reaction condition. The acetate was cleaved under basiccondition and converted to a carbamate (for example compound 10).Rhodium mediated intramolecular nitrene insertion of example compound 9,gave the target compound 11.Step 1:

To suspension of methyl triphenylphosphonium bromide (50.0 g, 0.140 mol)in 300 ml THF at 0° C. was added drop by drop 1.8M solution of PhLi inhexanes (71.5 ml, 0.129 mol) and stirred at rt for 30 min. The mixturewas cooled to −78° C. and a solution of 2 (25.2 g, 0.107 mol) in 130 mlTHF was added. The mixture was stirred for 15 min. at −78° C., 1 hr atrt then quenched with 1L of aq. NH₄Cl. The THF was evaporated and themixture was extracted with 4×300 ml of ether. The combined ether layerwas washed with 2×500 ml H₂O, 500 ml brine, dried over MgSO₄, filteredand concentrated. The crude product was chromatographed with 10:9EtOAc:hexanes to provide 19.8 g of 3.

¹H NMR (400 MHz, CDCl₃) 5.51 (dt, J=16.6, 10.2 Hz, 1H), 5.10-5.05 (m,2H), 4.69-4.62 (m, 1H), 2.66-2.59 (m, 1H), 2.26 (dt, J=10.0, 6.4 Hz,1H), 2.11 (dt, J=5.7, 10.1 Hz, 1H), 1.89-1.84 (m, 1H), 1.79-1.67 (m,4H), 1.43 (d, J=5.6 Hz, 3H), 1.30-1.12 (m, 3H), 1.07-0.97 (m, 3H),0.76-0.67 (m, 1H).Step 2:

To a solution of lactone 3 (4.75 g, 20.3 mmol) in 70 ml THF at rt wasadded 1M LiAlH₄ (20 ml, 20 mmol, 1 eq.) and mixture was stirred at rtfor 2 hr. The reaction was quenched by the addition of EtOAc, dilutedwith 300 ml H₂O and acidified with con. H₂SO₄. The mixture was extractedwith 3×100 ml EtOAc, combined organic layer was washed with 100 ml eachof H₂O and brine, dried over MgSO₄, filtered and evaporated to providethe crude diol as a resin.

To a solution of the above diol in 100 ml CH₂Cl₂ at −40° C. was addedEt₃N (4.3 ml, 30.9 mmol, 1.5 eq.) followed by TIPSOTf (6 ml, 22.3 mmol,1.1 eq.) drop-by-drop. The mixture was stirred for 1 hr and thetemperature was allowed to warm-up to 0° C. during that period. Thereaction mixture was poured into 200 ml aq. NaHCO₃, shaken, and theCH₂Cl₂ layer was separated. The aqueous layer was extracted with 2×100ml Et₂O and the combined organic layer was washed with brine, dried overMgSO₄, filtered and evaporated to provide 8.4 of alcohol as a resin.

To a solution of the above alcohol (4.9 g, 12.4 mmol) in 40 ml CH₂Cl₂was added NaHCO₃ (2.1 g, 25.0 mmol, 2 eq.), and Dess-Martin periodinane(6.3 g, 14.85 mmol, 1.2 eq.) and the mixture was stirred at rt for 1 hr.The solution was diluted with 50 ml Et₂O and 150 ml of aq.Na₂S₂O₃/NaHCO₃ mixture and stirred until the two layers became clear.The organic layer was separated and the aqueous layer was extracted with50 ml Et₂O. The combined organic layer was washed with brine, dried overMgSO₄, filtered and evaporate to provide ˜5 g of 4.

¹H NMR (400 MHz, CDCl₃) 5.47 (dt, J=17.0, 9.8 Hz, 1H), 5.03 (ddd,J=17.0, 2.2, 0.6 Hz, 1H), 4.98 (dd, J=10.2, 2.2 Hz, 1H), 3.50 (dd,J=10.4, 5.6 Hz, 1H), 3.32 (t, J=10.2 Hz, 1H), 3.24 (t, J=4.8 Hz, 1H),2.12 (s, 3H), 1.88-1.78 (m, 2H), 1.64-1.62 (m, 3H), 1.55-1.45 (m, 2H),1.34 (q, J=12.6 Hz, 1H), 1.23-0.83 (m, 26H), 0.61-0.52 (m, 1H).Step 3:

To a flask containing ketone 4 (˜5 g) in 30 ml of diethylene glycol wasadded anhydrous N₂H₄ (2 ml, 63.7 mmol, 5 eq.) followed by crushed KOH(3.5 g, 62.4 mmol, 5 eq.). The mixture was stirred at rt for about 15min. then heated overnight in an oil bath at ˜210° C. The reactionmixture was cooled to rt, diluted with 150 ml H₂O and extracted with3×50 ml Et₂O. The combined organic layer was washed with 2×50 ml H₂Ofollowed by 50 ml brine, dried over MgSO₄, filtered and evaporated toprovide the crude product. The crude was purified by flashchromatography eluting with 5% to 10% EtOAc in hexanes to provide 450 mgof 5.

¹H NMR (400 MHz, CDCl₃) 5.28 (dt, J=17.0, 10.6 Hz, 1H), 4.98 (dd,J=10.4, 2.4 Hz, 1H), 4.86 (ddd, J=17.2, 2.4, 0.4 Hz, 1H), 3.66 (dd,J=10.8, 3.2 Hz, 1H), 3.47 (dd, J=10.8, 6.4 Hz, 1H), 1.77-1.55 (m, 6H),1.50-1.40 (m, 3H), 1.23-1.11 (m, 4H), 0.94-0.78 (m, 2H), 0.69 (t, J=7.6,3H), 0.67-0.64 (m, 1H).Step 4:

To a solution of 5 (430 mg, 1.93 mmol), DMAP (24 mg, 0.20 mmol, 0.1 eq.)and Et₃N (540 μl, 3.87 mmol, 2 eq.) in 10 ml CH₂Cl₂ at 0° C. was addedacetyl chloride (275 μl, 3.87 mmol, 2 eq.) and stirred for 2.5 hr. Itwas diluted with 100 ml Et₂O, washed with 2×30 ml aq. NaHCO₃, 30 mlbrine, dried over MgSO₄, filtered and evaporated to provide 460 mg ofacetate.

A solution of the above product in 10 ml CH₂Cl₂ at −78° C. was bubbledwith ozone until the blue color persisted. The excess ozone was bubbledoff with N₂ and to this solution was added 2 ml of acetic acid, 2 g ofZn powder and few crystals of AgNO₃. The mixture was stirred at 0° C.for 1 hr, filtered through a celite pad and rinsed with Et₂O. Thefiltrate was washed with 2×30 ml H₂O, 2×30 ml aq. NaHCO₃, 30 ml brine,dried over MgSO₄, filtered and evaporated to provide 440 mg of 6.

¹H NMR (400 MHz, CDCl₃) 9.36 (d, J=5.6 Hz, 1H), 4.09 (dd, J=11.0, 2.6Hz, 1H), 3.91 (dd, J=11.0, 5.8 Hz, 1H), 2.01 (s, 3H), 1.95 (dt, J=10.4,5.6 Hz, 1H), 1.70-1.60 (m, 6H), 1.57-1.46 (m, 2H), 1.24-1.13 (m, 4H),1.02-0.82 (m, 4H), 0.764 (t, J=7.6 Hz, 3H).Step 5:

To a solution of phosphonate 7 (1.07 g, 3.31 mmol, 2 eq.) in 15 ml THFat 0° C. was added a solution of 2.5M BuLi in hexanes (1.32 ml, 3.30mmol, 2 eq.) and stirred for 20 min. To this was added Ti(O^(i)Pr)₄ (975μl, 3.30 mmol, 2 eq.) followed by a solution of aldehyde 6 (440 mg, 1.65mmol) in 3 ml THF. The mixture was stirred for 1 hr and poured into 100ml aq. sodium potassium tartrate solution. The aqueous slurry wasextracted with 3×30 ml EtOAc and the combined organic phase was washedwith 30 ml brine, dried over MgSO₄, filtered and evaporated to give aresidue. This was purified by chromatography to provide 510 mg of 8.

MS: m/e 436.1 (MH⁺)Step 6:

A mixture of 8 (500 mg, 1.15 mmol), K₂CO₃ (640 mg, 4.63 mmol, 4 eq.) in10 ml MeOH at rt was stirred for 3 hr, diluted with 100 ml aq. NH₄Cl andextracted with 3×30 ml Et₂O. The combined organic layer was washed with30 ml brine, dried over MgSO₄, filtered and evaporated to provide 450 mgof 9.

MS: m/e 394.1 (MH⁺)Step 7:

To a solution of 9 (86 mg, 0.219 mmol) in 2 ml CH₂Cl₂ at rt was addedtrichloroacetyl isocyanate (39 μl, 0.327 mmol, 1.5 eq.) and stirred for30 min. The solution was concentrated, dissolved in 2 ml MeOH andstirred with 6 mg of K₂CO₃ (0.043 mmol, 0.2 eq.) at rt for 1 hr. It wasconcentrated and chromatographed to provide 90 mg of 10.

MS: m/e 437.1 (MH⁺)Step 8:

A mixture of 10 (90 mg, 0.206 mmol), Rh₂(OAc)₄ (4.6 mg, 5 mol %),Phl(OAc)₂ (93 mg, 0.289 mmol, 1.4 eq.) and MgO (19 mg, 0.471 mmol, 2.3eq.) in 2 ml CH₂Cl₂ was heated overnight in a sealed tube (bath temp˜50° C.). The mixture was cooled to rt, concentrated and purified bychromatography to provide 18 mg of 11.

MS: m/e 435.1 (MH⁺)

Further embodiments of the invention encompass the administration ofcompounds of Formula I along with at least one additional agent. Thecontemplated additional agent is one that differs in either atomic makeup or arrangement from the compounds of Formula I. Additional agentsthat can be used in combination with the novel compounds of thisinvention include drugs which have anti-thrombotic, anti-plateletaggregation, antiatherosclerotic, antirestenotic and/or anti-coagulantactivity. Such drugs are useful in treating thrombosis-related diseasesincluding thrombosis, atherosclerosis, restenosis, hypertension, anginapectoris, angiogenesis related disorders, arrhythmia, a cardiovascularor circulatory disease or condition, heart failure, myocardialinfarction, glomerulonephritis, thrombotic stroke, thromboembolyticstroke, peripheral vascular diseases, cerebral ischemia, rheumatoidarthritis, rheumatism, astrogliosis, a fibrotic disorder of the liver,kidney, lung or intestinal tract, systemic lupus erythematosus, multiplesclerosis, osteoporosis, glomerulonephritis, renal disease, acute renalfailure, chronic renal failure, renal vascular homeostasis, renalischemia, bladder inflammation, diabetes, diabetic neuropathy, cerebralstroke, cerebral ischemia, nephritis, cancer, melanoma, renal cellcarcinoma, neuropathy and/or malignant tumors, neurodegenerative and/orneurotoxic diseases, conditions, or injuries, inflammation, asthma,glaucoma, macular degeneration, psoriasis, endothelial dysfunctiondisorders of the liver, kidney or lung inflammatory disorders of thelungs and gastrointestinal tract, respiratory tract disease orcondition, radiation fibrosis, endothelial dysfunction, periodontaldiseases or wounds or a spinal cord injury, or a symptom or resultthereof, as well as other disorders in which thrombin and its receptorplay a pathological role.

Suitable cardiovascular agents are selected from the group consisting ofthromboxane A2 biosynthesis inhibitors; thromboxane antagonists;adenosine diphosphate inhibitors; cyclooxygenase inhibitors; angiotensinantagonists; endothelin antagonists; phosphodiesterase inhibitors;angiotensin converting enzyme inhibitors; neutral endopeptidaseinhibitors; anticoagulants; diuretics; platelet aggregation inhibitors;and GP IIb/IIIa antagonists.

Preferred types of drugs for use in combination with the novel compoundsof this invention are thromboxane A2 biosynthesis inhibitors, GPIIb/IIIa antagonists, thromboxane antagonists, adenosine diphosphateinhibitors, cyclooxygenase inhibitors, angiotensin antagonists,endothelin antagonists, angiotensin converting enzyme inhibitors,neutral endopeptidase inhibitors, anticoagulants, diuretics, andplatelet aggregation inhibitors.

In particular, suitable cardiovascular agents are selected from thegroup consisting of aspirin, seratrodast, picotamide and ramatroban,clopidogrel, meloxicam, rofecoxib, celecoxib, valsartan, telmisartan,candesartran, irbesartran, losartan, eprosartan, tezosentan, milrinoone,enoximone, captopril, enalapril, enaliprilat, spirapril, quinapril,perindopril, ramipril, fosinopril, trandolapril, lisinopril, moexipril,benazapril, candoxatril, ecadotril, ximelagatran, fondaparin,enoxaparin, chlorothiazide, hydrochlorothiazide, ethacrynic acid,furosemide, amiloride, abciximab, eptifibatide, parsugrel and fragmin.

Especially preferred for use in the combinations are aspirin, cangrelor,clopidogrel bisulfate, parsugrel and fragmin.

When the invention comprises a combination of a compound of Formula Iand another agent, the two active components may be co-administeredsimultaneously or sequentially, or a single pharmaceutical compositioncomprising a compound of Formula I and another agent in apharmaceutically acceptable carrier can be administered. The componentsof the combination can be administered individually or together in anyconventional dosage form such as capsule, tablet, powder, cachet,suspension, solution, suppository, nasal spray, etc. The dosage of thecardiovascular agent can be determined from published material, and mayrange from 1 to 1000 mg per dose.

In this specification, the term “at least one compound of Formula I”means that one to three different compounds of Formula I may be used ina pharmaceutical composition or method of treatment. Preferably onecompound of Formula I is used. Similarly, the term “one or moreadditional cardiovascular agents” means that one to three additionaldrugs may be administered in combination with a compound of Formula I;preferably, one additional compound is administered in combination witha compound of Formula I. The additional agents can be administeredsequentially or simultaneously with reference to the compound of FormulaI.

For preparing pharmaceutical compositions from the compounds describedby this invention, inert, pharmaceutically acceptable carriers can beeither solid or liquid. Solid form preparations include powders,tablets, dispersible granules, capsules, cachets and suppositories. Thepowders and tablets may be comprised of from about 5 to about 95 percentactive ingredient. Suitable solid carriers are known in the art, e.g.magnesium carbonate, magnesium stearate, talc, sugar or lactose.Tablets, powders, cachets and capsules can be used as solid dosage formssuitable for oral administration. Examples of pharmaceuticallyacceptable carriers and methods of manufacture for various compositionsmay be found in A. Gennaro (ed.), The Science and Practice of Pharmacy,20^(th) Edition, (2000), Lippincott Williams & Wilkins, Baltimore, Md.

Liquid form preparations include solutions, suspensions and emulsions.As an example may be mentioned water or water-propylene glycol solutionsfor parenteral injection or addition of sweeteners and opacifiers fororal solutions, suspensions and emulsions. Liquid form preparations mayalso include solutions for intranasal administration.

Aerosol preparations suitable for inhalation may include solutions andsolids in powder form, which may be in combination with apharmaceutically acceptable carrier, such as an inert compressed gas,e.g. nitrogen.

Also included are solid form preparations which are intended to beconverted, shortly before use, to liquid form preparations for eitheroral or parenteral administration. Such liquid forms include solutions,suspensions and emulsions.

The compounds of the invention may also be deliverable transdermally.The transdermal compositions can take the form of creams, lotions,aerosols and/or emulsions and can be included in a transdermal patch ofthe matrix or reservoir type as are conventional in the art for thispurpose.

Preferably the compound is administered orally.

Preferably, the pharmaceutical preparation is in a unit dosage form. Insuch form, the preparation is subdivided into suitably sized unit dosescontaining appropriate quantities of the active component, e.g., aneffective amount to achieve the desired purpose.

The quantity of active compound in a unit dose of preparation may bevaried or adjusted from about 1 mg to about 150 mg, preferably fromabout 1 mg to about 75 mg, more preferably from about 1 mg to about 50mg, according to the particular application.

The actual dosage employed may be varied depending upon the requirementsof the patient and the severity of the condition being treated.Determination of the proper dosage regimen for a particular situation iswithin the skill of the art. For convenience, the total daily dosage maybe divided and administered in portions during the day as required.

The amount and frequency of administration of the compounds of theinvention and/or the pharmaceutically acceptable salts thereof will beregulated according to the judgment of the attending clinicianconsidering such factors as age, condition and size of the patient aswell as severity of the symptoms being treated. A typical recommendeddaily dosage regimen for oral administration can range from about 1mg/day to about 300 mg/day, preferably 1 mg/day to 75 mg/day, in two tofour divided doses.

When separate compounds of Formula I and the other agents are to beadministered as separate compositions, they can be provided in a kitcomprising in a single package, one container comprising a compound ofFormula I in a pharmaceutically acceptable carrier, and a separatecontainer comprising another cardiovascular agent in a pharmaceuticallyacceptable carrier, with the compound of Formula I and the other agentbeing present in amounts such that the combination is therapeuticallyeffective. A kit is advantageous for administering a combination when,for example, the components must be administered at different timeintervals or when they are in different dosage forms.

The activity of the compounds of formula I can be determined by thefollowing procedures.

In Vitro Testing Procedure for Thrombin Receptor Antagonists:

Preparation of [³H]haTRAP

A(pF-F)R(ChA)(hR)(I₂—Y)—NH₂ (1.03 mg) and 10% Pd/C (5.07 mg) weresuspended in DMF (250 μl) and diisopropylethylamine (10 μl). The vesselwas attached to the tritium line, frozen in liquid nitrogen andevacuated. Tritium gas (342 mCi) was then added to the flask, which wasstirred at room temperature for 2 hours. At the completion of thereaction, the excess tritium was removed and the reacted peptidesolution was diluted with DMF (0.5 ml) and filtered to remove thecatalyst. The collected DMF solution of the crude peptide was dilutedwith water and freeze dried to remove the labile tritium. The solidpeptide was redissolved in water and the freeze drying process repeated.The tritiated peptide ([³H]haTRAP) was dissolved in 0.5 ml of 0.1%aqueous TFA and purified by HPLC using the following conditions: column,Vydac™ C18, 25 cm×9.4 mm I.D.; mobile phase, (A) 0.1% TFA in water, (B)0.1% TFA in CH₃CN; gradient, (A/B) from 100/0 to 40/60 over 30 min; flowrate, 5 ml/min; detection, UV at 215 nm. The radiochemical purity of[³H]haTRAP was 99% as analyzed by HPLC. A batch of 14.9 mCi at aspecific activity of 18.4 Ci/mmol was obtained.

Preparation of Platelet Membranes

Platelet membranes were prepared using a modification of the method ofNatarajan et al. (Natarajan et al, Int. J. Peptide Protein Res.45:145-151 (1995)) from 20 units of platelet concentrates obtained fromthe North Jersey Blood Center (East Orange, N.J.) within 48 hours ofcollection. All steps were carried out at 4° C. under approved biohazardsafety conditions. Platelets were centrifuged at 100×g for 20 minutes at4° C. to remove red cells. The supernatants were decanted andcentrifuged at 3000×g for 15 minutes to pellet platelets. Platelets werere-suspended in 10 mM Tris-HCl, pH 7.5, 150 mM NaCl, 5 mM EDTA, to atotal volume of 200 ml and centrifuged at 4400×g for 10 minutes. Thisstep was repeated two additional times. Platelets were re-suspended in 5mM Tris-HCl, pH 7.5, 5 mM EDTA to a final volume of approximately 30 mland were homogenized with 20 strokes in a Dounce™ homogenizer. Membraneswere pelleted at 41,000×g, re-suspended in 40-50 ml 20 mM Tris-HCl, pH7.5, 1 mM EDTA, 0.1 mM dithiothreitol, and 10 ml aliquots were frozen inliquid N₂ and stored at −80° C. To complete membrane preparation,aliquots were thawed, pooled, and homogenized with 5 strokes of a Douncehomogenizer. Membranes were pelleted and washed 3 times in 10 mMtriethanolamine-HCl, pH 7.4, 5 mM EDTA, and re-suspended in 20-25 ml 50mM Tris-HCl, pH 7.5, 10 mM MgCl₂, 1 mM EGTA, and 1% DMSO. Aliquots ofmembranes were frozen in liquid N₂ and stored at −80° C. Membranes werestable for at least 3 months. 20 units of platelet concentratestypically yielded 250 mg of membrane protein. Protein concentration wasdetermined by a Lowry assay (Lowry et al., J. Biol. Chem., 193:265-275(1951)).

High Throughput Thrombin Receptor Radioligand Binding Assay

Thrombin receptor antagonists were screened using a modification of thethrombin receptor radioligand binding assay of Ahn et al. (Ahn et al.,Mol. Pharmacol., 51:350-356 (1997)). The assay was performed in 96 wellNunc plates (Cat. No. 269620) at a final assay volume of 200 μl.Platelet membranes and [³H]haTRAP were diluted to 0.4 mg/ml and 22.2 nM,respectively, in binding buffer (50 mM Tris-HCl, pH 7.5, 10 mM MgCl₂, 1mM EGTA, 0.1% BSA). Stock solutions (10 mM in 100% DMSO) of testcompounds were further diluted in 100% DMSO. Unless otherwise indicated,10 μl of diluted compound solutions and 90 μl of radioligand (a finalconcentration of 10 nM in 5% DMSO) were added to each well, and thereaction was started by the addition of 100 μl of membranes (40 μgprotein/well). The binding was not significantly inhibited by 5% DMSO.Compounds were tested at three concentrations (0.1, 1 and 10 μM). Theplates were covered and vortex-mixed gently on a Lab-Line™ Titer PlateShaker for 1 hour at room temperature. Packard UniFilter™ GF/C filterplates were soaked for at least 1 hour in 0.1% polyethyleneimine. Theincubated membranes were harvested using a Packard FilterMate™ UniversalHarvester and were rapidly washed four times with 300 μl ice cold 50 mMTris-HCl, pH 7.5, 10 mM MgCl₂, 1 mM EGTA. MicroScint™ 20 scintillationcocktail (25 μl) was added to each well, and the plates were counted ina Packard TopCount™ Microplate Scintillation Counter. The specificbinding was defined as the total binding minus the nonspecific bindingobserved in the presence of excess (50 μM) unlabeled haTRAP. The %inhibition by a compound of [³H]haTRAP binding to thrombin receptors wascalculated from the following relationship:% Inhibition=Total binding-Binding in the presence of a testcompound×100 Total binding-Nonspecific bindingMaterials

A(pF-F)R(ChA)(hR)Y—NH₂ and A(pF-F)R(ChA)(hR)(I₂—Y)—NH₂, were customsynthesized by AnaSpec Inc. (San Jose, Calif.). The purity of thesepeptides was >95%. Tritium gas (97%) was purchased from EG&G Mound,Miamisburg, Ohio. The gas was subsequently loaded and stored on an IN/USSystems Inc. Trisorber. MicroScint™ 20 scintillation cocktail wasobtained from Packard Instrument Co.

Cannabinoid CB₂ Receptor Binding Assay

Binding to the human cannabinoid CB₂ receptor was carried out using theprocedure of Showalter, et al. (1996, J. Pharmacol Exp Ther. 278(3),989-99), with minor modifications. All assays were carried out in afinal volume of 100 ul. Test compounds were re-suspended to 10 mM inDMSO, then serially diluted in 50 mM Tris, pH 7.1, 3 mM MgCl₂, 1 mMEDTA, 50% DMSO. Aliquots (10 ul) of each diluted sample were thentransferred into individual wells of a 96-well microtiter plate.Membranes from human CB₂ transfected CHO/Ki cells (Receptor Biology,Inc) were re-suspended in binding buffer (50 mM Tris, pH 7.1, 3 mMMgCl2, 1 mM EDTA, 0.1% fatty acid free bovine serum albumin), then addedto the binding reaction (˜15 ug in 50 ul per assay). The reactions wereinitiated with the addition of [³H] CP-55, 940 diluted in binding buffer(specific activity=180 Ci/mmol; New England Nuclear, Boston, Mass.). Thefinal ligand concentration in the binding reaction was 0.48 nM.Following incubation at room temperature for 2 hours, membranes wereharvested by filtration through pretreated (0.5% polyethylenimine; SigmaP-3143) GF-C filter plates (Unifilter-96, Packard) using a TomTec™ Mach3U 96-well cell harvester (Hamden, Conn.). Plates were washed 10 timesin 100 ul binding buffer, and the membranes allowed to air dry.Radioactivity on membranes was quantitated following addition of PackardOmniscint™ 20 scintillation fluid using a TopCount™ NXT MicroplateScintillation and Luminescence Counter (Packard, Meriden, Conn.).Non-linear regression analysis was performed using Prism™ 20b. (GraphPadSoftware, San Diego, Calif).

Using the test procedures described above, representative compounds offormula I were found to have thrombin receptor IC₅₀ values (i.e., theconcentration at which a 50% inhibition of thrombin receptor wasobserved) of 1 to 1000 nM, preferably 1-100 nM, more preferably 1-20 nM.CB₂ Ki values range from 1 to 1000 nM, preferably 1-200 nM, morepreferably 1-100 nM.

1. A compound represented by structural formula I:

or a pharmaceutically acceptable salt of said compound, wherein

represents a double bond or a single bond, as permitted by the valencyrequirement; with the proviso that R¹⁰ is absent when the carbon towhich R¹⁰ is attached is part of a double bond; B is —(CH₂)_(n3)—,—(CH₂)—O—, —(CH₂)S—, —(CH₂)—NR⁶—, —C(O)NR⁶—. —NR⁶C(O)—,

—(CH₂)_(n4)CR¹²═CR^(12a)(CH₂)_(n5)— or —(CH₂)_(n4)C≡C(CH₂)_(n5)—,wherein n₃ is 0-5, n₄ and n₅ are independently 0-2, and R¹² and R^(12a)are independently selected from the group consisting of hydrogen, alkyland halogen; A, E, G, J, K, M and U are independently selected from thegroup consisting of —N(R⁵⁴)—, —(CR¹R²)—, —O—,

—S—, —S(O)—, —S(O)₂— and

with the provisos that selection of A, E, G, J, K, M and U does notresult in adjacent oxygen or sulfur atoms and that at least one carbonatom appear between said oxygen, nitrogen or sulfur atoms; each n is 0,1 or 2 with the provisos that all n variables cannot be 0 and that thetotal of n variables cannot be greater than 7; Het is a mono-, bi- ortricyclic heteroaromatic group of 5 to 14 atoms comprised of 1 to 13carbon atoms and 1 to 4 heteroatoms independently selected from thegroup consisting of N, O and S, with the proviso that there are noadjacent oxygen or sulfur atoms present in the heteroaromatic group,wherein a ring nitrogen can form an N-oxide or a quaternary group withan alkyl group, wherein Het is attached to B by a carbon atom ringmember, and wherein the Het group is substituted by 1 to 4 moieties, W,wherein each W is independently selected from the group consisting ofhydrogen; alkyl; fluoroalkyl; difluoroalkyl; trifluoroalkyl; cycloalkyl;heterocycloalkyl; heterocycloalkyl substituted by alkyl or alkenyl;alkenyl; R²¹-arylalkyl; R²¹-aryl-alkenyl; heteroaryl; heteroarylalkyl;heteroarylalkenyl; hydroxyalkyl; dihydroxyalkyl; aminoalkyl;alkylaminoalkyl; di-(alkyl)-aminoalkyl; thioalkyl; alkoxy; alkenyloxy;halogen; —NR⁴R⁵; —CN; —OH; —C(O)OR¹⁷; —COR¹⁶; —OS(O₂)CF₃; —CH₂OCH₂CF₃;alkylthio; —C(O)NR⁴R⁵; —OCHR⁶-phenyl; phenoxyalkyl; —NHCOR¹⁶; —NHSO₂R¹⁶;biphenyl; —OC(R⁶)₂COOR⁷; —OC(R⁶)₂C(O)NR⁴R⁵; alkoxy substituted by alkyl,amino or —NHC(O)OR¹⁷; aryl; aryl substituted by 1 to 3 substituentsindependently selected from the group consisting of alkyl, halogen,alkoxy, methylenedioxy, carboxylic acid, carboxamide, amine, urea,amide, sulfonamide, —CN, —CF₃, —OCF₃, —OH, alkylamino-,di-(alkyl)amino-, —NR²⁵R²⁶alkyl-, hydroxyalkyl-, —C(O)OR¹⁷, —COR¹⁷,—NHCOR¹⁶, —NHS(O)₂R¹⁶, —NHS(O)₂CH₂CF₃, —C(O)NR²⁵R²⁶, —NR²⁵—C(O)—NR²⁵R²⁶,—S(O)R¹⁶, —S(O)₂R¹⁶ and —SR¹⁶; or alkyl optionally substituted with—NR¹R², —NR¹COR², —NR¹CONR¹R², —NR¹C(O)OR², —NR¹S(O)₂R², —NR¹S(O)₂NR¹R²,—C(O)OH, —C(O)OR¹, —CONR¹R²heteroaryl, hydroxyalkyl, alkyl or—S(O)₂-alkyl;—C(O)NR⁴R⁵ or heteroaryl;wherein adjacent carbons on theHet ring can optionally form a ring with a methylenedioxy group; R¹ andR² are independently selected from the group consisting of hydrogen,alkyl, fluoroalkyl, difluoroalkyl, trifluoroalkyl, cycloalkyl, alkenyl,alkoxy, arylalkyl, arylalkenyl, heteroarylalkyl, heteroarylalkenyl,hydroxy, hydroxyalkyl, alkoxyalkyl, aminoalkyl, aryl and thioalkyl; orR¹ and R² when attached to nitrogen, taken together, form a mono orbicyclic heterocyclic ring of 4 to 10 atoms, with 1-3 heteroatomsselected from —O—, —N—, —S—, —S(O)—, —S(O)₂— and

with the proviso that S and O ring atoms are not adjacent to each other,where said heterocyclic ring is unsubstituted or substituted with one ormore groups selected from alkyl, halogen, hydroxy, alkoxy, aryloxy andarylalkoxy; R⁶ is hydrogen, alkyl or phenyl; R⁷ is hydrogen or alkyl;each R¹³ is independently selected from hydrogen, alkyl, cycloalkyl,haloalkyl, halogen, —(CH₂)_(n6)NHC(O)OR^(16b), —(CH₂)_(n6)NHC(O)R^(16b),—(CH₂)_(n6)NHC(O)NR⁴R⁵, —(CH₂)_(n6)NHSO₂R¹⁶, —(CH₂)_(n6)NHSO₂NR⁴R⁵, and—(CH₂)_(n6)C(O)NR²⁸R²⁹, where n₆ is 0-4; each R¹⁴ is independentlyselected from the group consisting of hydrogen, alkyl, —OH, alkoxy,arylalkyl, heteroaryl, heteroarylalkyl, heterocyclyl, heterocyclylalkyl,halogen, haloalkyl, —(CH₂)_(n6)NHC(O)OR^(16b), —(CH₂)_(n6)NHC(O)R^(16b),—(CH₂)_(n6)NHC(O)NR⁴R⁵, —(CH₂)_(n6)NHSO₂R¹⁶, —(CH₂)_(n6)NHSO₂NR⁴R⁵, and—(CH₂)_(n6)C(O)NR²⁸R²⁹ where n₆ is 0-4; where R⁴ and R⁵ areindependently selected from the group consisting of hydrogen, alkyl,phenyl, benzyl and cycloalkyl, or R⁴ and R⁵ together can form a ringwith the nitrogen to which they are attached, wherein said ring formedby R⁴ and R⁵ is optionally substituted with ═O, OH, OR¹ or —C(O)OH; orR¹³ and R¹⁴ taken together form a spirocyclic or a heterospirocyclicring of 3-6 ring atoms, wherein said heterospirocyclic ring contains 2to 5 carbon ring atoms and 1 or 2 hetero ring atoms selected from thegroup consisting of O, S and N; R¹⁶ is independently selected from thegroup consisting of hydrogen, alkyl, phenyl and benzyl; R^(16a) isindependently selected from the group consisting of hydrogen, alkyl,phenyl and benzyl; R^(16b) is hydrogen, alkoxy, alkyl, alkoxyalkyl-,R²²—O—C(O)-alkyl-, cycloalkyl, R²¹-aryl, R²¹-arylalkyl, haloalkyl,alkenyl, halo substituted alkenyl, alkynyl, halo substituted alkynyl,R²¹-heteroaryl, (R²¹-heteroaryl)-alkyl-, (R²¹-heterocycloalkyl)-alkyl-,R²⁸R²⁹N-alkyl-, R²⁸R²⁹N—C(O)-alkyl-, R²⁸R²⁹N—C(O)O-alkyl-,R²⁸OC(O)N(R²⁹)-alkyl-, R²⁸S(O)₂N(R²⁹)-alkyl-,R²⁸R²⁹N—C(O)—N(R²⁹)-alkyl-, R²⁸R²⁹N—S(O)₂N(R²⁹)-alkyl-,R²⁸—C(O)N(R²⁹)-alkyl-, R²⁸R²⁹N—S(O)₂-alkyl-, HOS(O)₂-alkyl-,(OH)₂P(O)₂-alkyl-, R²⁸—S-alkyl-, R²⁸-S(O)₂-alkyl- or hydroxyalkyl; R¹⁷is independently selected from the group consisting of hydrogen, alkyl,phenyl and benzyl; R¹⁸ and R¹⁹ are hydrogen, alkyl, aryl, R²¹-aryl,heteroaryl, cycloalkyl, heterocyclyl, alkoxyalkyl, haloalkoxyalkyl,aryloxyalkyl, arylalkoxyalkyl, heteroaryloxyalkyl,heteroarylalkoxyalkyl, cycloalkyloxyalkyl, (heterocyclyl)alkyloxyalkyl,alkoxyalkyloxyalkyl, —S(O)₂-alkyl, —C(NH)NR¹R² or alkyl substituted withone or two moieties selected from cycloalkyl, halogen, hydroxy, —NR¹R²,—NR¹C(O)R², —NR¹C(O)NR¹R², —NR¹C(O)OR², —NR¹S(O)₂R², —NR¹S(O)₂NR¹R²,—C(O)OH, —C(O)OR¹ and —C(O)NR¹R²; or R¹⁸ and R¹⁹ together with thenitrogen to which they are attached, form a mono or bicyclicheterocyclic ring of 4 to 10 atoms, having 1-3 hetero ring atomsselected from —O—, —N—, —S—, —S(O)—, —S(O)²⁻ and

with the proviso that S and O atoms are not adjacent to each other, thering being unsubstituted or substituted with one or more groups selectedfrom alkyl, halogen, hydroxy, alkoxy, aryloxy, arylalkoxy, —NR¹R²,—NR¹COR², —NR¹C(O)NR¹R², —NR¹C(O)OR², —NR¹S(O)₂R², —NR¹S(O₂)NR¹R²,—C(O)OR¹, —CONR¹R² and alkyl substituted with —NR¹R², —NR¹COR²,—NR¹CONR¹R², —NR¹C(O)OR², —NR¹S(O)₂R², —NR¹S(O)₂NR¹R², —C(O)OR¹ or—CONR¹R²; R²¹ is 1 to 3 moieties and each R²¹ is independently selectedfrom the group consisting of hydrogen, —CN, —CF₃, —OCF₃, halogen, —NO₂,alkyl, —OH, alkoxy, alkylamino-, di-(alkyl)amino-, —NR²⁵R²⁶alkyl-,hydroxyalkyl-, —C(O)OR¹⁷, —COR¹⁷, —NHCOR¹⁶, —NHS(O)₂R¹⁶, —C(NH)—NH₂,—NHS(O)₂CH₂CF₃, —C(O)NR²⁵R²⁶, —NR²⁵—C(O)—NR²⁵R²⁶, —S(O)R¹⁶, —S(O)₂R¹⁶,—SR¹⁶; —SO₂NR⁴R⁵ and —CONR⁴R⁵; or two adjacent R²¹ moieties can form amethylenedioxy group; R²² is hydrogen, alkyl, phenyl, benzyl, —COR¹⁶,—CONR¹⁸R¹⁹, —COR²³, —S(O)R³¹, —S(O)₂R³¹, —S(O₂)N²⁴R²⁵ or —C(O)OR²⁷; R²³is

wherein R³⁵ and R³⁶ are independently selected from the group consistingof hydrogen, alkyl, and R³⁷-substituted alkyl, wherein R³⁷ is selectedfrom the group consisting of HO—, HS—, CH₂S—, —NH₂, phenyl,p-hydroxyphenyl and indolyl; or R²³ is alkyl; haloalkyl; alkenyl;haloalkenyl; alkynyl; cycloalkyl; cycloalkylalkyl; cycloalkylsubstituted by 1 to 3 substituents selected from the group consisting ofalkoxyalkyl, alkyl, halogen, hydroxy, alkoxy, aryloxy, arylalkoxy,—NR¹R², —NR¹C(O)R², —NR¹C(O)NR¹R², —NR¹C(O)OR², —NR¹S(O)₂R²,—NR¹S(O)₂NR¹R², —C(O)OH, —C(O)OR¹ and —CONR¹R²; aryl; aralkyl;heteroaryl; heterocycloalkyl; alkyl substituted with —NR¹R², —NR¹COR²,—NR¹CONR¹R², —NR¹C(O)OR², —NR¹S(O₂)R², —NR¹S(O₂)NR¹R², —C(O)OH,—C(O)OR¹, —CONR¹R² and —SO₃H; R²⁴, R²⁵ and R²⁶ are independentlyselected from the group consisting of hydrogen, alkyl, haloalkyl,alkenyl, alkynyl, aryl, aralkyl, cycloalkyl, halocycloalkyl,alkoxyalkyl, hydroxy and alkoxy; R²⁷ is 1 to 3 moieties and each R²⁷ isselected from the group consisting of hydrogen, alkyl, and cycloalkyl,wherein R²⁷ is optionally substituted with —OH, —C(O)OH, halogen andalkoxy; R²⁸ and R²⁹ are independently selected from the group consistingof hydrogen, alkyl, alkoxy, arylalkyl, heteroaryl, heteroarylalkyl,hydroxyalkyl, alkoxyalkyl, heterocyclyl, heterocyclylalkyl, andhaloalkyl; or R²⁸ and R²⁹ taken together form a spirocyclic or aheterospirocyclic ring having 3-6 ring atoms; R³² and R³³ areindependently selected from the group consisting of hydrogen, R³⁴-alkyl,R³⁴⁻alkenyl, R³⁴-alkynyl, R⁴⁰-heterocycloalkyl, R³⁸-aryl, R³⁸-aralkyl,R⁴²-cycloalkyl, R⁴²-cycloalkenyl, —OH, —OC(O)R⁴³, —C(O)OR⁴³, —C(O)R⁴³,—C(O)NR⁴³R⁴⁴, —NR⁴³R⁴⁴, —NR⁴³C(O)R⁴⁴, —NR⁴³C(O)NR⁴⁴R⁴⁵, —NHS(O)₂R⁴³,—OC(O)NR⁴³R⁴⁴, R³⁷-alkoxy, R³⁷-alkenyloxy, R³⁷-alkynyloxy,R⁴⁰-heterocycloalkyloxy, R⁴²-cycloalkyloxy, R⁴²-cyclo-alkenyloxy,R⁴²-cycloalkyl-NH—, —NHSO₂NHR¹⁶ and —CH(═NOR¹⁷); or R³² and R³³ arecombined to form a ring structure Q, below

where R⁹ is hydrogen, OH, alkoxy, halogen or haloalkyl; Q is fusedR-substituted aryl, R-substituted heteroaryl, R-substituted heterocyclicring of 4-8 atoms containing 1-3 heteroatoms selected from O, S, S(O),S(O)₂ and NR²² with the proviso that S and O cannot be adjacent to oneanother; or Q is

R¹⁰ and R¹¹ are independently selected from the group consisting of R¹,fluoroalkoxy, difluoroalkoxy, trifluoroalkoxy, cycloalkyloxy,alkenyloxy, arylalkoxy, arylalkenyloxy, heteroarylalkoxy,heteroarylalkenyloxy, hydroxyalkoxy, alkoxyalkoxy, aminoalkoxy, aryloxyand thioalkoxy, provided that when ring Q is aromatic and the carbonatoms bearing R¹⁰ and R¹¹ are connected by a double bond, R¹⁰ and R¹¹are absent; R is 1 to 5 moieties and each R is independently selectedfrom the group consisting of hydrogen, alkyl, halogen, hydroxy, amino,alkylamino, dialkylamino, alkoxy, —COR¹⁶, —C(O)OR¹⁷, —C(O)NR⁴R⁵, —SOR¹⁶,—S(O₂)R¹⁶, —NR¹⁶COR^(16a), —NR¹⁶C(O)OR^(16a), —NR¹⁶CONR⁴R⁵,—NR¹⁶S(O₂)NR⁴R⁵, fluoroalkyl, difluoroalkyl, trifluoroalkyl, cycloalkyl,alkenyl, arylalkyl, arylalkenyl, heteroarylalkyl, heteroarylalkenyl,hydroxyalkyl, aminoalkyl, aryl and thioalkyl; R³⁴ is 1 to 3 moieties andeach R³⁴ is independently selected from the group consisting ofhydrogen, halogen, —OH, alkoxy, R⁴⁷-aryl, alkyl-C(O)—, alkenyl-C(O)—,alkynyl-C(O)—, heterocycloalkyl, R³⁹-cycloalkyl, R³⁹-cycloalkenyl,—OC(O)R⁴³, —C(O)OR⁴³, —C(O)R⁴³, —C(O)NR⁴³R⁴⁴, —NR⁴³R⁴⁴, —NR⁴³C(O)R⁴⁴,—NR⁴³C(O)NR⁴⁴R⁴⁵, —NHSO₂R⁴³, —OC(O)NR⁴³R⁴⁴, R³⁹-alkenyloxy,R³⁹-alkynyloxy, R⁴⁰-heterocycloalkyloxy, R⁴²-cycloalkyloxy,R⁴²-cycloalkenyloxy, R⁴²-cycloalkyl-NH—, —NHSO₂NHR¹⁶ and —CH(═NOR¹⁷);R³⁸ is 1 to 3 moieties and each R³⁸ is independently selected from thegroup consisting of hydrogen, heterocycloalkyl, halogen, —C(O)OR⁴⁸, —CN,—C(O)NR⁴⁹R⁵⁰, —NR⁵¹C(O)R⁵², —OR⁴⁸, cycloalkyl, cycloalkylalkyl,alkylcycloalkylalkyl, haloalkylcycloalkylalkyl, hydroxyalkyl,alkoxyalkyl, and R⁵²-heteroaryl; or two R³⁸ groups on adjacent ringcarbons form a fused methylenedioxy group; R³⁹ is 1 to 3 moieties andeach R³⁹ is independently selected from the group consisting ofhydrogen, halogen and alkoxy; R⁴⁰ is 1 to 3 moieties and each R⁴⁰ isindependently selected from the group consisting of hydrogen, R⁴¹-alkyl,R⁴¹-alkenyl and R⁴¹-alkynyl; R⁴¹ is hydrogen, —OH or alkoxy; R⁴² is 1 to3 moieties and each R⁴² is independently selected from the groupconsisting of hydrogen, alkyl, —OH, alkoxy and halogen; R⁴³, R⁴⁴ and R⁴⁵are independently selected from the group consisting of hydrogen, alkyl,alkoxyalkyl, R³⁸-arylalkyl, R⁴⁶-cycloalkyl, R⁵³⁻cycloalkylalkyl,R³⁸-aryl, heterocycloalkyl, heteroaryl, heterocycloalkylalkyl andheteroarylalkyl; R⁴⁶ is hydrogen, alkyl, hydroxyalkyl or alkoxy; R⁴⁷ is1 to 3 moieties and each R⁴⁷ is independently selected from the groupconsisting of hydrogen, alkyl, —OH, halogen, —CN, alkoxy, trihaloalkoxy,alkylamino, di(alkyl)amino, —OCF₃, hydroxyalkyl, —CHO, —C(O)alkylamino,—C(O)di(alkyl)amino, —NH₂, —NHC(O)alkyl and —N(alkyl)C(O)alkyl; R⁴⁸ ishydrogen, alkyl, haloalkyl, dihaloalkyl or trifluoroalkyl; R⁴⁹ and R⁵⁰are independently selected from the group consisting of hydrogen, alkyl,aralkyl, phenyl and cycloalkyl, or R⁴⁹ and R⁵⁰ together are —(CH₂)₄—,—(CH₂)₅— or —(CH₂)₂—NR³⁹—(CH₂)₂— and form a ring with the nitrogen towhich they are attached; R⁵¹ and R⁵² are independently selected from thegroup consisting of hydrogen, alkyl, aralkyl, phenyl and cycloalkyl, orR⁵¹ and R⁵² in the group —NR³⁹C(O)R⁴⁰, together with the nitrogen atomsto which they are attached, form a cyclic lactam having 5-8 ringmembers; R⁵³ is hydrogen, alkoxy, —SOR¹⁶, —SO₂R¹⁷, —C(O)OR¹⁷,—C(O)NR¹⁸R¹⁹, alkyl, halogen, fluoroalkyl, difluoroalkyl,trifluoroalkyl, cycloalkyl, alkenyl, aralkyl, arylalkenyl,heteroarylalkyl, heteroarylalkenyl, hydroxyalkyl, aminoalkyl, aryl,thioalkyl, alkoxyalkyl or alkylaminoalkyl; and R⁵⁴ is selected from thegroup consisting of hydrogen; alkyl; fluoroalkyl; difluoroalkyl;trifluoroalkyl; cycloalkyl; cycloalkyl substituted by 1 to 3substituents selected from the group consisting of alkoxyalkyl, alkyl,halogen, hydroxy, alkoxy, aryloxy, arylalkoxy, —NR¹R², —NR¹C(O)R²,—NR¹C(O)NR¹R², —NR¹C(O)OR², —NR¹S(O)₂R², —NR¹S(O)₂NR¹R², —C(O)OH,—C(O)OR¹ and —CONR¹R²; alkenyl; alkoxy; arylalkyl; arylalkenyl;heteroarylalkyl; heteroarylalkenyl; hydroxy; alkoxy; hydroxyalkyl;alkoxyalkyl; aminoalkyl; aryl; heteroaryl; thioalkyl and alkylsubstituted by 1 to 3 subsituents selected from the group consisting ofurea, sulfonamide, carboxamide, carboxylic acid, carboxylic ester andsulfonyl urea; and pharmaceutically acceptable salts thereof.
 2. Acompound of claim 1 of the following formula:


3. A compound of claim 1 of the following fomula


4. A compound of claim 1 wherein E is NR⁵⁴.
 5. A compound of claim 1wherein E is —C(O)—.
 6. A compound of claim 1 wherein A is —C(R¹R²)—. 7.A compound of claim 1 wherein A is —S(O)₂—.
 8. A compound of claim 1wherein A is C(O).
 9. A compound of claim 1 wherein A and M are eachindependently CH₂.
 10. A compound of claim 4 wherein n of A_(n) andM_(n) is 0, 1 or
 2. 11. A compound of claim 1 wherein G or U are N. 12.A compound of claim 1 wherein R³² and R³³ are combined to form the ringstructure Q.
 13. A compound of claim 1 wherein A is N and E is O.
 14. Acompound of claim 1 wherein A is O and E is N.
 15. A compound of claim 1wherein A_(n) is —C(R¹R²)—, —C(O)— or S(O)₂, E is —C(O)— or NR⁵⁴; M_(n)is —CH₂—; n, for A_(n) and M_(n), is 0, 1 or 2; and R³² and R³³ arecombined to form a ring structure Q.
 16. A compound of claim 1 whereinA_(n) is —C(R¹R²)—, —C(O)— or S(O)₂; E is —C(O)— or NR⁵⁴; M_(n) is—CH₂—; and n, for A_(n) and M_(n), is 0, 1 or
 2. 17. A compound of claim1 wherein B is —(CH₂)_(n4)CR¹²═CR^(12a)(CH₂)_(n5)— wherein n₄ and n₅ are0.
 18. A compound of claim 1 wherein Q is


19. A compound of claim 1 wherein W is aryl, heteroaryl or arylsubstituted by halogen or —CN.
 20. A compound of claim 1 wherein W isaryl substituted with halogen.
 21. A compound of claim 1 wherein W is


22. A compound of claim 1 wherein K_(n) is —CH(CH₂CH₃)— and n is
 1. 23.A compound of claim 1 wherein the following ring portion of the compoundof formula I,


24. A compound of claim 1 wherein J_(n) is —CH₂— where n is
 1. 25. Acompound of claim 1 wherein R⁹, R¹⁰ and R¹¹ are H.
 26. A compound ofclaim 1 wherein the following ring portion of the compound of formula I,

W is

B is —(CH₂)_(n4)CR¹²═CR^(12a)(CH₂)_(n5)— wherein n₄ and n₅ are 0; J_(n)is —CH₂— where n is 1 and R⁹, R¹⁰ and R¹¹ are H.
 27. A compound of claim1 with the following formula:


28. A pharmaceutical composition comprising an effective amount of acompound of claim 1 and a pharmaceutically acceptable carrier.
 29. Amethod of inhibiting thrombin receptors comprising administering to amammal in need of such treatment an effective amount of a compound ofclaim
 1. 30. A method of treating thrombosis, atherosclerosis,restenosis, hypertension, angina pectoris, angiogenesis relateddisorders, arrhythmia, a cardiovascular or circulatory disease orcondition, heart failure, acute coronary syndrome, myocardialinfarction, glomerulonephritis, thrombotic stroke, thromboembolyticstroke, peripheral vascular diseases, deep vein thrombosis, venousthromboembolism, a cardiovascular disease associated with hormonereplacement therapy, disseminated intravascular coagulation syndrome,cerebral infarction, migraine, erectile dysfunction, rheumatoidarthritis, rheumatism, astrogliosis, a fibrotic disorder of the liver,kidney, lung or intestinal tract, systemic lupus erythematosus, multiplesclerosis, osteoporosis, renal disease, acute renal failure, chronicrenal failure, renal vascular homeostasis, renal ischemia, bladderinflammation, diabetes, diabetic neuropathy, cerebral stroke, cerebralischemia, nephritis, cancer, melanoma, renal cell carcinoma, neuropathy,malignant tumors, neurodegenerative and/or neurotoxic diseases,conditions or injuries, Alzheimer's disease, an inflammatory disease orcondition, asthma, glaucoma, macular degeneration, psoriasis,endothelial dysfunction disorders of the liver, kidney or lung,inflammatory disorders of the lungs and gastrointestinal tract,respiratory tract disease or condition, radiation fibrosis, endothelialdysfunction, periodontal diseases or wounds, or a spinal cord injury, ora symptom or result thereof, comprising administering to a mammal inneed of such treatment an effective amount of at least one compound ofclaim
 1. 31. The method of claim 30 wherein the inflammatory disease orcondition is irritable bowel syndrome, Cohn's disease, nephritis or aradiation- or chemotherapy-induced proliferate or inflammatory disorderof the gastrointestinal tract, lung, urinary bladder, gastrointestinaltract or other organ.
 32. The method of claim 30 wherein the respiratorytract disease or condition is reversible airway obstruction, asthma,chronic asthma, bronchitis or chronic airways disease.
 33. The method ofclaim 30 wherein the cancer is renal cell carcinoma or an angiogenesisrelated disorder
 34. The method of claim 30 wherein theneurodegenerative disease is Parkinson's disease, amyotropic lateralsclerosis, Alzheimer's disease, Huntington's disease or Wilson'sdisease.
 35. The method of claim 30 further comprising administering atleast two therapeutically effective agents.
 36. A method of treatingthrombosis, atherosclerosis, restenosis, hypertension, angina pectoris,angiogenesis related disorders, arrhythmia, a cardiovascular orcirculatory disease or condition, heart failure, acute coronarysyndrome, myocardial infarction, glomerulonephritis, thrombotic stroke,thromboembolytic stroke, peripheral vascular diseases, deep veinthrombosis, venous thromboembolism, a cardiovascular disease associatedwith hormone replacement therapy, disseminated intravascular coagulationsyndrome, cerebral infarction, migraine, erectile dysfunction,rheumatoid arthritis, rheumatism, astrogliosis, a fibrotic disorder ofthe liver, kidney, lung or intestinal tract, systemic lupuserythematosus, multiple sclerosis, osteoporosis, renal disease, acuterenal failure, chronic renal failure, renal vascular homeostasis, renalischemia, bladder inflammation, diabetes, diabetic neuropathy, cerebralstroke, cerebral ischemia, nephritis, cancer, melanoma, renal cellcarcinoma, neuropathy, malignant tumors, neurodegenerative and/orneurotoxic diseases, conditions or injuries, Alzheimer's disease, aninflammatory disease or condition, asthma, glaucoma, maculardegeneration, psoriasis, endothelial dysfunction disorders of the liver,kidney or lung, inflammatory disorders of the lungs and gastrointestinaltract, respiratory tract disease or condition, radiation fibrosis,endothelial dysfunction, periodontal diseases or wounds, or a spinalcord injury, or a symptom or result, comprising administering to amammal in need of such treatment an effective amount of a compound ofclaim 1 in combination with at least one additional cardiovascularagent.
 37. The method of claim 36 wherein the additional cardiovascularagent or agents is selected from the group consisting of thromboxane A2biosynthesis inhibitors, GP IIb/IIIa antagonists, thromboxaneantagonists, adenosine diphosphate inhibitors, cyclooxygenaseinhibitors, angiotensin antagonists, endothelin antagonists, angiotensinconverting enzyme inhibitors, neutral endopeptidase inhibitors,anticoagulants, diuretics, and platelet aggregation inhibitors.
 38. Themethod of claim 37 wherein the additional cardiovascular agent or agentsare selected from the group consisting of aspirin, cangrelor,clopidogrel bisulfate, parsugrel and fragmin.
 39. The method of claim 38wherein the additional cardiovascular agents are aspirin and clopidogrelbisulfate.
 40. The method of claim 38 wherein the additionalcardiovascular agents are aspirin and parsugrel.
 41. A method ofinhibiting cannabinoid receptors comprising administering to a mammal inneed of such treatment an effective amount of at least one compound ofclaim
 1. 42. A compound of claim 1 in purified form.
 43. A compound ofclaim 1 in isolated form.
 44. A method of treating or preventingradiation- or chemical-induced toxicity in non-malignant tissue in apatient comprising administering a therapeutically effective amount of acompound of claim
 1. 45. The method of claim 44 wherein the radiation-and/or chemical-induced toxicity is one or more of intestinal fibrosis,pneumonitis, intestinal mucositis, oral mucositis, intestinal radiationsyndrome, or pathophysiological manifestations of intestinal radiationexposure.
 46. A method of reducing structural radiation injury in apatient that will be exposed, is concurrently exposed, or was exposed toradiation and/or chemical toxicity; reducing inflammation in a patientthat will be exposed, is concurrently exposed, or was exposed toradiation and/or chemical toxicity; adverse tissue remodeling in apatient that will be exposed, is concurrently exposed, or was exposed toradiation and/or chemical toxicity; or reducing fibroproliferativetissue effects in a patient that will be exposed, is concurrentlyexposed, or was exposed to radiation and/or chemical toxicity,comprising administering a therapeutically effective amount of acompound of formula I.
 47. A method of treating a cell proliferativedisorder in a patient suffering therefrom comprising administering atherapeutically effective amount of a compound of formula I.
 48. Themethod of claim 47 wherein the cell proliferative disorder is pancreaticcancer, glioma, ovarian cancer, colorectal cancer, colon cancer, breastcancer, prostate cancer, thyroid cancer, lung cancer, melanoma, orstomach cancer.
 49. The method of claim 48 wherein the glioma is ananaplastic astrocytoma or a glioblastoma multiforme.